Cosmetic Dentistry Cannot Cure Vanity

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4 Jul 2016 - General

I love cosmetic work. I love transforming people's smiles or restoring their teeth back to health. I love it when I am able to restore patients' confidence and they come out of the clinic feeling brandnew. That's the high for us doctors: providing patient satisfaction. Recently, though, I've realized that there are certain patients that I'd rather not encounter. 

Last year I treated two patients in their 70s (both female) and they both came to me with cosmetic issues. Both had existing crowns; both came to me with a collection of old photos (from when they were in their 20s or 30s) and photos of celebrities; both were also undergoing a series of cosmetic work on their arms, lips, eyebags, etc. They were both very nice. They loved to talk and I would listen. They would come to the clinic with food and random trinkets. It was so easy to love them. 

And then we got to the middle of treatment (and I've gone past so many other patients and cases I was simultaneously working on along with theirs) but we couldn't seem to finish. They would always find something wrong. One time the other "okayed" the set of crowns on the left quadrant of the mouth and she proudy went home with it (temporarily cemented). She wanted to test-drive it, so to speak, she took it to a party and she was sending me pictures of her smile--she was obviously very happy and I felt so good. But when I saw her again in the clinic, she had a list of things she wanted the lab to work on. That went on and on. The same is true for the second patient and I should've known because the first time she came in, she was asking me what I thought about the work another doctor did on her arms (if I thought they were fine or they were even). 

I'm telling you I am afraid of these patients now. Don't mistake me, I love challenges... but I spent more than a year on the first patient--for a case I could've done in two months max. Sometimes it's not worth it. How do you satisfy patients that are never satisfied with themselves?

That's basically what I did with the patient. I saw it through to the end, until she was happy. Towards the end, all her appointments were done in the presence of the lab technician and changes were being made as she points it out. In terms of earning---that's where the compromise is. After a more than a year (she would even spend minimum of 2 hours per clinic visit), how do you "collect" more than what's initially arranged? It's a per unit cost (per unit of crown), whi...
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One way could be to continue to operating on the same individual in the way he/she instructs (and earning). That is how many people do it. If you feel ethically uncomfortable, you can refer to colleagues who are not feeling uncomfortable. It should be noted that these patients often are a high litigation risk. The other way that is important would be to perform a easy screen for body dyspmorphic disorders. If a patient is found to have a high chance for it, it would be help to refer the patient...
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