Seeking that Hollywood smile

Oct. 1, 2000
I would like to have some cosmetic work done on my maxillary anterior teeth, but my present boss does very little of this type of dentistry.

I would like to have some cosmetic work done on my maxillary anterior teeth, but my present boss does very little of this type of dentistry.

Dianne Glasscoe, RDH, BS

Dear Dianne,

I have been a hygienist for 10 years and have worked in this practice for about three years. I would like to have some cosmetic work done on my maxillary anterior teeth, but my present boss does very little of this type of dentistry. He is a wonderful person and treats all the staff members with respect and caring. However, his cosmetic dentistry skills are less than ideal. Multiple attempts at good outcomes seem to be typical.

I love my job, and dread offending my present boss. Would it hurt his feelings if I have my veneers done in another office?

Sensitive in Seattle

Dear Sensitive,

The emergence of cosmetic dentistry has opened up a completely new field in the profession. While many dentists attempt to jump on the bandwagon and position themselves as "cosmetic" dentists, only a few possess the expertise and artistic ability to excel in this field.

Becoming highly skilled in cosmetic dentistry requires a considerable investment of time and money. Doctors must be willing to take good comprehensive courses to learn the proper techniques.

Competition between dental practices is like comparing a group of fishermen. Some fishermen are content to sit on the pier with their cane pole and bait, catching crappie or bream to their heart`s content. These fishermen probably won`t land a whopper, but under the right conditions, they can catch a bucketful in a short time. The fishing is fun and puts food on the table. Other fishermen like to go after more challenging fish. They buy a bass boat, invest in expensive equipment, and travel to distant lakes in search of big fish. Still other fishermen buy sophisticated equipment, hire a guide, and travel to some remote location to catch the trophy fish. Doctors position themselves and their practices to attract certain kinds of "fish."

Some dentists have no desire to learn cosmetic dentistry. They are content with their practices and income levels. They and have no need to invest in extra training and coursework.

Other dentists simply do not possess the artistic flair needed to produce fine esthetic dentistry. Cosmetic dentistry is as much art as science; textbooks can`t train an eye for fine detail or teach the nuances of shading.

Still other dentists prefer not to deal with a population group that is demanding and hard to please. Doctors who deal primarily in cosmetics will readily admit that there are patients who refuse to be satisfied, even when the outcome is beautiful.

Cosmetic dentistry also requires the services of a quality lab, which is quite expensive. Dentist must adjust their fees accordingly to remain profitable. Some doctors are not comfortable with charging high fees.

Whether or not your boss would be offended depends on his personality. If his skills truly are limited, he may in fact be relieved if you go elsewhere. However, if he has a sizable ego, he may indeed be offended - initially. I expect that, with time, he will get over it. The experience may motivate him to improve his own skills.

Another angle worth considering is turning this into a win-win situation for both of you. How? The doctor could invite the laboratory technician into the office during your preps for collaboration. He might also do the whole procedure with the assistance of another doctor who is skilled in cosmetics. Your doctor could gain invaluable insight into cosmetic dentistry, and you could get your veneers without offending him. There is no substitute for hands-on learning.

Tactfully inform your boss of your decision, and listen carefully to his response. Depending on his answer, you might ask, "How would you feel about assisting Dr. Cosmetic Dentist on my case," or "How would you feel about doing them, with Dr. Cosmetic Dentist collaborating?"

Certainly, going elsewhere without telling him first would be even more hurtful. If you decide to let another dentist do your veneers, assure your employer that you will not be referring patients to the other practice. Tell your boss that you would not offend him for the world and that you hope he will understand. If you have a good working relationship with your boss, it should not be an issue. Please let me know how this turns out so I may share what you learned with all my readers. Best wishes with your new porcelain veneers!


Dianne Glasscoe, RDH, BS, is an adjunct instructor in clinical hygiene at Guilford Technical Community College. She holds a bachelor`s degree in human resource management and is a practice-management consultant, writer, and speaker. She may be contacted by e-mail at [email protected], phone (336) 472-3515, or fax (336) 472-5567. Visit her Web site at http://www.professionalden