One of the most difficult aspects of cosmetic dentistry is the element of subjectivity in assessing esthetic goals.

Dr. Olitsky on Cosmetic Case ChallengesWhat seems excellent and attractive to a dentist may be very different from what a patient has in mind. Complications arise out of this divide and can grow from miscommunications.

Below, Dr. Olitsky reflects on the non-technical issues that make for disheartening cases and a recent situation in his practice where he was at odds with a patient.

Cosmetic Rx: Challenging Cases, Unrealistic Expectations, and Patient Concerns

I continue to learn from every patient encounter. One would think with the amount of cosmetic dentistry I perform and the level of detail under which I operate that failing to meet patient expectations is an impossibility, but this is not true.

My most challenging cases are not with the teeth but with the brains. How do I get a patient to realize that this is very good esthetic dentistry when they have no prior experiences to compare? Patients may have many unrealistic expectations of restorative results. For example, during a recent appointment I had a long conversation with a patient about why the gums go in around a #19 implant crown when I had just recently finished her full mouth rehabilitation. My explanation was not good enough for her.

Why was she not informed of this ahead of time? What else could have been done? The fact that she had no other esthetic or treatment concerns regarding the other 29 units of dentistry did not affect her assessment of this one critical consideration. She also wasn’t affected by the amount of times I saw her to make sure everything was perfect.

The patient fixated on the tissue around the posterior implant despite my many attempts to prevent dissatisfaction. I just have to realize that there are going to be patients I love to treat and others that despite my best efforts will make me question my decisions in life. I have to focus on the positives and still come out loving what I do. I should only lose sleep if I didn’t give something my best.

Have you had similar issues arise in your practice? We’d love to hear your thoughts in the comments!