dental braces figure a

We hear it all the time: “I want my teeth to look better, longer, wider … and I DON’T want braces!” Frustrating, right?

Yet when you think about it, why would any adult really want braces?

They are ugly, they hurt, the process is lengthy and they’ve seen friends and kids struggle with them. I wouldn’t want them either.

What do you hear when a patient says that they don’t want braces? Do you hear NO? Maybe you hear, “Find another way because I don’t want to hear about braces!” Or you could possibly hear, “Don’t go any further, I already said NO.”

The patient in the photos told me she didn’t want braces. She gave me all the reasons; she didn’t like her smile and she didn’t like that her “little front teeth” (laterals) were different sizes. On top of those reasons, she hated that her smile was lopsided (midline off) and she reiterated that she didn’t want braces. (Figures 1 and 2)

dental braces figure 1
dental braces figure 2

That is not an unreasonable request – she doesn’t know what we know. All she understood was that having braces sounded horrible and she wanted no part of it. Wasn’t there some way I could help her without ortho?

We have to lead our patients through a process of discovery and decision-making if we want them to see a different outcome for themselves. By using graphics and asking questions, we can often help patients see their current condition differently and reach the optimal conclusion on their own.

In this patient's case, I used the template system we teach here at Spear to show her a comparison of where her tooth position is, and where it needs to be in order to give her what she asked for. (Figure 3)

dental braces figure 3
dental braces figure 4

By showing her the image and asking her what she saw, she began to understand that she had a choice; restore her teeth in the position in which they were and sacrifice the esthetics she wanted or move the teeth orthodontically to get what she asked for. She did her treatment and got a result that she loves. (Figure 4)

Not every patient will make that choice - but unless we give them the opportunity to see what is possible, they will never say yes. We have risk hearing NO before we can hear YES.

(Click this link to read more dentistry articles by Dr. Steve Ratcliff.)

Steve Ratcliff, D.D.S., M.S., Spear Faculty and Contributing Author


Commenter's Profile Image Phillip G. Pitts Sr.
June 25th, 2014
Interest in becoming a member of Spear Education. Phillip G. Pitts Sr. LinkedIn
Commenter's Profile Image John Sweeney
June 26th, 2014
Nice post Steve, yeah I agree 100%. I have also found that as dentists, we are so eager to start the restorative case we short change the ortho conversation and mention it almost in passing but not fully engaging the patient in the discovery process. I was like this early in my career but have gone full circle. Almost 50% of our large restorative cases have or will be undergoing ortho. It makes things so much more predictable and allows me to be more conservative with tooth structure.
Commenter's Profile Image Meranie Merlien
February 27th, 2015
I'm interested in this post. I have braces now and I am very upset with how my midline alignment is now compared to how it was before I got those braces. How can I get in contact with you because I'm eager to try this method immediately.