No Half Smiles, ever
In 2006, I came up with a concept called “No Half Smiles”. This is a treatment philosophy which rejects what I like to call “partial dentistry”, focusing instead on treating every oral issue a patient may have. In most developed countries, going to the dentist is almost like going to the hairdresser: you get there, you tell the hairdresser how you want your hair to look, you pay them and off you go with the job done! A version of this is happening quite a lot in dentistry, where patients may have 10 cavities and an infected tooth, but all they want to do is fix their chipped front tooth because that’s what people see when they smile. Now, of course dentistry is a business, but it is a healthcare business, and so I have to ask: am I caring for your health if I ignore serious problems and only fix the cosmetic ones?
So, the way I create an adequate treatment plan for my patients is, firstly, to break down the potential problems into three groups: biological, mechanical, and cosmetic. Some patients will have one of these issues, some may have two or three, but our aim is to take care of all of them. The starting point should always be the treatment of the biological issues, so the first thing we always do at our clinic is locate any cysts, infections, impacted teeth, etc., and then we come up with a plan to address these problems. Obviously, it takes time and may cost some money, but we need to build the house before we can decorate it, right? “No Half Smiles” also means no half jobs, and if we were to focus solely on the cosmetic problems, we wouldn’t be in the healthcare industry, we would be in the beauty industry.
Then, we’ll take care of the mechanical problems, and here is where we see if the patient requires orthodontics to correct the position of their teeth, if they need implants (which is always done after orthodontics, because implants do not move), etc. All of this is a must, because if you just focus on quick fixes you are not helping your patients, and that should be priority number one. I actually think that is why most dentists are stressed all the time: they give in to what one patient wants, and they know they’re not helping them, but it’s not a big deal because it’s just a one-time thing. And then it happens again. And again. Suddenly, it’s 5 years later and this partial dentistry has turned into their business model. They are now seeing 20 or 30 people a day, 30 minutes per person, and don’t even have time to process things properly, which ultimately means they end up overworked and overstressed. That is not right and this is not the answer – not for the practitioner, not for the patient.
Only after taking care of the biological and mechanical (or functional) issues will I direct my attention to the aesthetic issues. As you can see, aesthetics are the last thing we work on. We must build the foundations first; we must take care of the patient’s health before doing anything else. And even if the patient has a limited budget, you should always give precedence to biological and take care of that first, instead of going straight to cosmetics. I know it may be hard, because most patients just want to fix what looks bad, but you have to say NO. That’s what “No Half Smiles” is all about: saying NO to quick fixes, saying NO to half dentistry, saying NO to half treatment plans, saying NO to pretty smiles on the outside, but unhealthy smiles on the inside.