J O U R N A L O F F.!SlI4ITI(: D E N T I S T R Y

Premises

V A L U E : I F YOU D O N ’ T S E E IT, W H O W I I . l . ?

urn back a page in this Journal and you will see ou r title page. It offers ou r publication T to “All Who Endeavor to Do Fine Dentistry.” Deep within those few words resides the essence of our purpose as esthetic practitioners: “fine dentistry.” We have studied it, we have perfected it, we teach it to others. But do we truly value our life’s work? For if we fail to value it, how likely is it that others will recognize its worth?

Let us first ask ourselves if we deserve to be valued. Who could disagree? The fact that you subscribe to and read a journal devoted to esthetic practice suggests the answer is yes. Pursuing continuing education indicatcs that you arc striving to be the very best you can be. It is a journey you have pursued over years-through dental school, internship, and now prac- tice or instructing others.

Yet so many dentists have been so buffeted by a third party payment system that appears to devalue their efforts that their own sense of worth ha5 been eroded in the process. Since these forces show no signs of abating, it is essential for us to stand tall against them, asserting thc value and benefit of the unique service we perform.

How do we put a price tag on a potentially life-changing proccss like restoring an individual’s worn, aged, or damaged dention? As you wcll know, changing a smile often means changing a life. The benefits include not only the obvious esthetic and functional improvcmcnts but also the social, professional, and economic bcnefits that accrue to so many o f ou r patients. How many patients have written you post-treatment notes describing the “incredible changes” that have come as a result of their new smiles? How many report a boost in self-esteem, iniprovcd relationships, and even the increased professional opportunities they have realized? How can these be fairly quantified by a standardized structure such as the infamous ‘‘LICR?”

No standard of insurance can properly incorporate the time, talcnt, skill, and professional judgment required to make an old smile young again, or to restore an unsightly, unhealthy mouth to beauty and function. If we value these outcomes, and the processes required to achieve them, we must establish and stand by fees that are not merely reflections of the technical aspects of a case but ones that embrace the artistry, skill, and especially the intangible value of our services as well.

V O I I I M I . n . N L I M R t K I 1Y7

J O U R N A L OP ESTHETIC D E N T I S 7 R Y

This can be hard to do, especially in areas where a majority of patients depend on insurance coverage. Yet we have seen practitioners in rural communities, in agricultural areas, and in small towns who have maintained the highest level of esthetic practice, been unafraid to charge for their services, and attracted a large and loyal patient following. Key to their success was a fundamental belief in the value of their work. We must not lower our standards to accept payment that is not commensurate with our skill and effort.

It is incumbent upon us to step beyond the boundaries imposed by the UCR. We must continue to educate our patients to raise their expectations about the outcome of esthetic dental treatment, not reduce them in the face of rigidities imposed by the insurance system. We must continue to stand for fine dentistry and all that it entails, which includes personal satisfaction as well as remuneration. Who of us would be content to return to a steady diet of cleanings and fillings and abandon the incredible emotional and personal satisfaction that comes from completing a full-mouth or anterior restoration for an appreciative patient?

There is no turning back the tide of HMOs and managed care as it relates to dentistry. What were once trends have become the norm. Wishing them away will have no effect. Rather, we must strengthen our resolve to value our abilities and the value of the service we render.

Ronald E . Goldstein, DDS David A. Garber, DMD Editors-in- Chief

Journal of Esthetic Dentistry