Emotional Dentistry

Dr Sam Jethwa shines a light on why cosmetic dentistry is more than just about appearance and reveals the role of the dental nurse in delivering aesthetic dental procedures

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Head dental nurse Lauren assisting on a smile makeover course (taken pre-COVID-19).

Dr Sam Jethwa BDS (Lon) MFDS RCS (Edin) PgDip ClinEd provides advanced and cosmetic dentistry at Bespoke Smile & The Perfect Smile Studio, founded The Bespoke Smile Academy for dentists, and is director of communications at the British Academy of Cosmetic Dentistry (BACD).

For more, visit https://bacd.com When we talk about cosmetic dentistry, referring to it as purely an aesthetic procedure doesn’t quite do it justice. Cosmetic dentistry could be described, in my opinion, as ‘emotional dentistry’. That is why there has been no decline in the delivery or demand of cosmetic dentistry following the impact of the pandemic.

The quest for an emotional change to one’s life, does not simply disappear because there is a pandemic, or the world is in lockdown – and for the person involved, as soon as its possible to make that change, they will – and that is why we exist: to provide our patients with the positive emotional change, that they so desire.

I run clinics that are focused on advanced and cosmetic care and there has been little decline and have found a similar level of uptake for cosmetic procedures, possibly slightly more than usual since March 2020.

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What are patients primarily seeking?

All aspects of cosmetic dentistry are more popular than ever. Our clinics are geared towards ultra-thin porcelain veneers, cosmetic braces and Invisalign, along with dental implants – we are seeing huge demand for all treatments.

How important is good communication when it comes to cosmetic dentistry?

Communicating how cosmetic dentistry can help patients is vital to increase awareness and allow patients to explore a wide range of treatments. The wider team is possibly more important than the dentist themselves, as we find our patient care coordinators, care nurses, and hygiene therapists play a vital role when communicating with patients.

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What technologies and equipment have changed the way you deliver smile makeovers?

My workflows for porcelain veneer smile makeovers are tried and tested. Any modifications to these protocols needs to involve testing and auditing of results for a lengthy period of time in order to ensure quality control.

However, 3D scanning software has slotted in seamlessly into the clinic, with workflows of their own. We can now digitally scan all our patients to avoid messy impressions, and this technology means quicker turnarounds, too. We can also predict movements of teeth for treatments such as Invisalign and show patients the end results before we start.

What is The Hand Sculpted Trial Smile?

This is my secret weapon. The traditional way to produce porcelain veneers for a patient’s new smile is to send working impressions to the laboratory who create the veneers for the dentist to cement onto the prepared teeth.

With a handmade trial smile instead of relaying the information to a laboratory technician, the clinician creates in the patient’s mouth, on the teeth themselves and produces hand sculpted temporary veneers, with no laboratory template.

A thorough understanding of dental aesthetics is needed for this technique to be successful. It allows patients to leave with the new design, and test this for a period of time so they have an input into the look, and bite before the final porcelain is made. In our clinic, our care nurses play a huge part in assisting the creation of the trial smiles, often guiding the dentists and helping patient with decisions on shape, colour, and proportion.

How important is minimally invasive dentistry?

A key part of success long term is to ensure enamel is preserved when placing veneers, and minimally invasive dentistry is always the goal. We have learnt how damaging the natural tooth is not in the patient’s best interests, and it becomes more and more important when younger patients are seeking cosmetic dentistry.

It is important that as dentists we explain to patients what the long- term effect of their treatment choices are, not just the short term.

Do you believe cosmetic dentistry offers opportunities for dentists and dental nurses to create their own USPs and unique skill sets?

Absolutely. In our clinic, our care nurses play a crucial role and are considered cogs that make the machine work. Without them, our workflows and patient journeys fall apart. From photography, impression taking to treatment coordinating, our team are involved in every aspect.

Is cosmetic dentistry well-suited as a platform for team members looking to progress their career?

Most definitely! Specific training on customer service, phone skills, business development, all helps to grow our clinical team individually in terms of their USPs and personal skill sets.

How important is for teams to stay up to date with the latest developments in the profession?

If the clinics want to stay ahead, it is critical that enhancements in technology are embraced by the practice. In our clinic, our nurses use the intra oral scanner, are able to set up imaging devices such as the cone beam CT and OPG and are skilled in providing nursing for implant dentistry, which involves 3D printed surgical guides. Staying up to date and moving with the times, really gives a team member that edge within the dental profession.

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Patient care coordinator Aimie with a patient celebrating his new smile

meet the team at Bespoke Smile Dentistry

Training academy coordinator Anup with trainee dental nurse Jessie.

What can dental nurses do to make themselves indispensable in an aesthetic-focused dental practice?

Show a true passion for learning, hard work, and be genuinely interested about the process of smile makeovers. Playing a role in the whole process from communicating the treatments, and understanding the clinical aspects, whilst supporting the patients and sharing their excitement.

What key skills do they require (implant dental nursing/photography/orthodonticnursing etc)

Communication, communication, communication! Plus excellent infection control, awareness of CQC regulations, and a highly organised mindset. Efficiency we find is the key when working in a high demand cosmetic practice, and being proactive rather than reactive.

It can be so rewarding for dental teams to be given responsibilities and further training such as impression taking, radiography, photography, and specialist treatments.

How important is it to have a dental nurse who can communicate well with patients and walk them through their patient journey?

As mentioned above, this is so important when working around patients and a team where treatment plans involve a number of visits, a team of clinicians and dental care professionals. Care nurses are the port of call for patients, and are there to provide a trusting and caring channel of communication.

Spending time learning and becoming a true expert care nurse in cosmetic dentistry will allow easy communication with patients where often many questions are asked as the treatments are more complex than usual.

How key is oral health education throughout the smile makeover process?

Success long term for smile makeovers is heavily related to how well results are maintained. We ask our patients to visit our hygiene therapist every three to six months or our periodontist where required, but oral health advice during the smile makeover process and afterwards is imperative to produce the best results. The whole dental team can play a part in this.

Does the BACD welcome dental nurses as members?

The British Academy of Cosmetic Dentistry (BACD) is always open to welcoming any dental care professional and we do find a number of dental nurses attend the BACD aesthetic dentistry theatre at The Dentistry Show each year.

The board of directors at the BACD is always looking at ways of collaborating with other academies and professional bodies to provide support and relevant education – and dental nurses are a key part of cosmetic dentistry now and for the future.

Why is aesthetic dentistry booming during a pandemic?

  • Greater time to attend visits whilst working from home or furloughed.
  • Virtual consultations making it easier to access advice and care from professional dentists who usually would have long waiting lists.
  • More savings to spend on things like cosmetic dentistry. For those who have retained jobs, there have been fewer expenses in 2020, with limited travel and socialising.
  • It’s now or never. There is a sense of urgency because things that we enjoy are being taken away from us as a result of the pandemic, so ‘if I don’t do it now, when will I?’
  • Limited socialising and mask wearing could be a good time to consider treatments that may involve visible appliances like braces.