The final case presentation should be a carefully prepared, easily understood treatment plan. Visual aids, before and after photographs, slides, models, intra- and extraoral video and computer imaging, and examples of the procedures to be used assist in communicating the possibilities and limitations of esthetic treatment.

These are three basic methods for helping patients visualize your suggested solutions for their individual esthetic problems:

1. Soft, Tooth-Colored Wax or Composite Resin Applied Directly in the Mouth

The advantages to this technique are:

• it is the least costly for the patient;

• it is the quickest method;

• it is especially useful in space or diastema problems.

2. A Waxed Study Model

When the potential solution to an esthetic problem requires extensive tooth preparation, this method can be effective for those patients who are used to visualizing plans, such as an architectural blueprint (Figure 2-17). The waxed model is also important from a diagnostic standpoint when your patient has a space problem. By preparing the teeth, then waxing them, you can determine if there is too much or too little space for normal-sized tooth replacement. This allows you to adjust the treatment plan as necessary to make certain you can create an adequate esthetic restoration.

3. Computer Imaging

By far, esthetic imaging is the best method to help your patient visualize your intended corrections. The printouts and the image on the monitor can be effective communication tools. This method also allows you to easily alter your treatment plan to reflect various compromises. Rarely will it be necessary for your patient to return for further imaging if you have thought of possible options in advance. It is also extremely effective to show your patient the various choices, since most people will opt for the best look, provided they can find a way to afford the correction.

For patients with complex problems, the combination of computer imaging and waxed diagnostic models will be the best choice for complete visualization.

WHEN NOT TO TREAT… BUT TO REFER
It is impossible for any one dentist, regardless of how capable he or she is, to satisfy every patient’s esthetic needs. Most new patients are on their best behavior during the initial interview session. That is why it takes a skilful dentist and staff, as well as extra time, to ascertain what kind of patient is presenting to your office. Your goal is to determine who should be the patient you refer. To help with the decision, the following patient-type categories can be incorporated into your treatment philosophy.

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