diagnostic wax-up figure 1
Do you make a diagnostic wax-up before you even talk to the patient about treatment?

Pretty diagnostic wax-up in this image, don’t you think?

I have paid for hundreds of these over the past 30 years. And early in my career I paid for dozens and then never got to do the case. I had been taught that if I really wanted to get a patient to say yes, I must have a beautiful diagnostic wax-up. If I had these wax-ups on an articulator and a second unaltered set of models also on an articulator so that the patient could appreciate my vast technical knowledge and how hard I had worked on their case, then of course they couldn’t help but write a check.

The only problem was that no one told my patients or they missed the memo, because most of them said no. To make matters worse, I didn’t have the confidence to actually charge them for these wax-ups, so I was in a financial hole before I even talked about the case.

Here’s the issue I faced. The wax-up represented my treatment plan, not a treatment plan that my patient had asked for. I gathered all the data, came back with my best solution and then asked if they had any questions. Of course, they didn’t. They were in sticker shock or treatment shock. Many had come in for what they thought was a check up and cleaning, and I was telling them they needed thousands of dollars of work.

In our core workshops here at Spear Education, we focus on helping our participants understand and implement a very logical and linear system of diagnosis and treatment planning, which in turn helps improve case acceptance. A significant part of these courses are discussions on how to involve the patient from the very first appointment so that they have the greatest opportunity to fully appreciate their present condition, understand the implications of not treating what is present, and their options for treatment with all of the inherent risks and benefits.

Most people will not choose the “what” without understanding the “why.” And they won’t ask why unless they can experience for themselves what we are talking about.

We teach the use of photographs and how to use those images to engage the patient in the process. At the chair we are actively involving the patient in the exam process so they can ask questions during the entire data gathering process.

Most people learn visually – not all, but most. Using visual experiences helps them to grasp the concepts or conditions you are explaining. Years ago, I used a pen and bracket table cover and drew lots pictures. Today, digitally, we have the most amazing tools to help our patients learn and understand concepts that are often difficult to grasp.

Spear has developed patient education tools in the form of 3-D animations that explain both conditions and procedures in a short, accurate and clear format. They are designed to be viewed with the patient and to stimulate conversation. When viewed with the doctor and key staff member, these videos provide opportunities to dig deeper into what may be in the patient’s long-term best interest.

When people understand what is happening in their mouths and you can relate it to their long-term preferred outcomes (e.g. “I want to keep my teeth till I die”), they are more likely to ask for the treatment you know you can provide. And they are often more willing to pay for that wax-up before you have it done.

There are no guarantees that any treatment presentation method is foolproof. However, your case acceptance will grow if you wait for the patient to ask for treatment rather than force your ideas at them.


Commenter's Profile Image Chad C.
August 18th, 2016
I did that myself once 10 years ago. $800 for a wax up never did the case. It only took me once to learn! Thinking back now, with the skills I have obtained at Spear since then I'm glad I didn't do the case I probably would have screwed it up.