This patient has the highest standard of esthetic excellence. Unless you are willing to spend an inordinate amount of diagnostic and treatment time with this patient, you are much better off, emotionally and financially, making an early decision to refer this patient. Deciding to treat this type of patient may mean charging two, three, or even four times your normal fee in order to cover the extra time, stress, laboratory and office costs, and extended warranty for this patient. Offices that elect to do this should also consider the probability of having to redo the treatment several times in an attempt to satisfy this patient’s esthetic and functional demands. Will it be worth it and can your office afford this type of expense? Too often, dentists find that treating these patients costs them so much they would have paid another dentist double the amount after they have failed in their attempts to satisfy the patient. Although many of us may enjoy a challenge, the question is, can your office afford the risk of taking on such a challenge?

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