Lunch and Learn (cont.)
While taking all this education, we realized that there needs to be a differentiation between a busy, family style cosmetic dentist, one on each corner in Jacksonville, to a cosmetic dentist focusing on smile enhancement procedures. We realized that integrating the proper level of care for patients who needed our services could not happen properly in a family style practice. We could not be everything to everybody. In essence, we had to choose to differentiate ourselves based on our primary focus in our office. It takes a huge increase in time, education, money and commitment to learn to do it the best way for the patient. Our expenses due to the training, materials and increased lab costs of using the best lab cause our treatment costs to go up. We are not able to charge the same thing as the other offices around town, but we try to keep the prices down. Most offices charge around 1K per tooth. Smile Care doctors, most who have no advanced training and use inexpensive labs, charge 1K per tooth. They are going to profit considerably more than us, when we incur lab costs alone that are $200 more per veneer plus our increased cost of education and equipment. We have to charge more just to stay even and it should not be construed as a larger profit margin to the patients. You get what you pay for in cosmetic dentistry. So there is complacency among cosmetic dentists that their veneers are good enough, because of the large gap that occurs between the family style cosmetic dentist and the dentist who has a primary focus on smile enhancement procedures. This is an emotional decision for our guests. We need to take the time to really get to know them personally. Personal attention, it costs to much money to shove them in time slots next to hygiene checks. Patients are beginning to expect more. They want clean and neat facilities that are modern and high tech with a little pampering. Only the best stuff, not CEREC and Lumineers. CEREC looks so fake, the machine processes out of single colored ingot or a three shade ingot. They need to be thicker and have no artistry. It's like an Empress veneer that has not been cut back by the ceramist. It is marketed as done in one day and it is a huge compromise for the patient and it is sad and unfortunate that a dentist would do that way. One day they will be for sure, but not yet, not even close. Lumineers are a no prep veneer. They do a lot of marketing that sounds good to patients, but they look fake compared to an actual tooth and that is what we are talking about. Two things in the same place do not work. Margins will always be bulky and finished improperly interpoximally. There will be no incisal characteristics unless lengthening the incisor by 2 mm and they will be opaque to mask out the underlying tooth. They look like chicklets. I took a call from a patient who saw some before and afters at an office down the street. She asked me if I did Lumineers. I was nice, but honest, that they where not my preference because they looked fake compared to how a veneer should look. She said that they looked good in the book that lumineers furnished the dentist. She didn't know that, but I did. So we are lowering the expectations of our patients so we can do Lumineers, a process we learned to do in a weekend, so that we could start Monday morning. I think that is sad for the profession. What they should say is this is the best I can do, but if you want it more natural then go to a dentist who is passionate about smiles, but they don't, because its really good money, because Lumineers are a cheap lab bill, really cheap to do in the office, and they charge the same thing. They just have no clue what good veneers look like and I'm starting to get mad.....
Cernate is a feldspathic veneer. They can be made by any ceramist with some training and there are some really good ones, but Cernates is a mill that outsources their work to China not a highly qualified skilled ceramist. We do feldspathic veneers, but not from cerinates. We still prep them in 98% of the cases. Feldspathic is good for minimal changes or tetracycline cases, but most ceramists rather do pressed because it is waxed to full contour and cutback and layered. The skill of the ceramist is what makes the veneers look so natural. Our ceramist is cutting back to whole ingot now layering in at the margins and incisal so they look so natural and blend in to the tooth seamlessly. We actually do no prep veneers in our office, but most patients are not good candidates for a no prep veneer. Only about 2% of our cases are good for no preparation veneers. The rest would have a lot of cosmetic compromises. Our no prep veneers are made by a talented ceramist, not my a large mill type lab like Cerinates. We will happily discuss options with a patient including prep and no prep veneers and other alternatives that are even more conservative.
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