These are the patients who cannot communicate what they want because they do not themselves know what they want. They may show you a picture of exactly what they want, but when they eventually see it in their mouth, they may be terribly disappointed. Even study models with wax-ups may look good to these patients, but that approval may be of no benefit when the final restoration is in their mouth. What can be most frustrating is to show this type of patient a computer image of his or her enhanced smile, which may be enthusiastically received but, amazingly, not appreciated when tried in. The problem is, these people really do not know what they want when it comes to their own appearance. Typically, they have difficulty making up their minds in other areas of their lives as well. They may be constantly redecorating their homes, apartments, or offices. They may be frequently frustrated with their hairstyles and constantly changing their barber or hairstylist in an attempt to find that “perfect” style. The real problem here is identifying this type of patient before agreeing to treat them. This is one of the hardest categories to identify because, at first glance, these people seem so easy to please. You may be tempted to proceed with treatment too hastily only to find that you, in fact, are now treating the type of patient you may have wished you had referred. One important clue to help you recognize this patient type is that he or she presents to you in the middle of treatment from another office. Frequently, that dentist may have redone their treatment many times before the patient sought another opinion. If this is the situation, carefully analyze the treatment with which the patient presents. Has it been done poorly? Is it esthetically inferior? Frequently, the patient will state “I hear you’re the best.” Although we all like to think we can do something better, “better” may, however, be just another failure to this problem patient. And the sad situation is that few, if any, practitioners may be able to satisfy this patient. Frequently, the root of the problem is psychological. The patient may not truly know what he or she wants. Other times he or she is looking for your esthetic dentistry to solve a problem that only a psychologist or psychiatrist can solve.

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