Solutions for Patients Seeking Cosmetic Dentistry

Brian Harris, DDS, and Matt Muscolo

These days, anyone with a social media account knows how much emphasis is placed on esthetics. Our feeds are inundated with celebrities and influencers showing off brand-new smiles thanks to cosmetic solutions, such as clear aligners, whitening treatments, veneers, and even implants. The image that these influencers project can impact the sentiments of everyday people, and researchers and practitioners alike have noted that social media may be driving people to seek out these treatments to get that quintessential "Hollywood smile."¹

It is widely recognized that oral health not only affects what is going on in the mouth but also has a significant impact on overall physical health.² Consequently, more people are carrying dental insurance to help them pay for oral healthcare than in the past. According to the National Association of Dental Plans, dental coverage availability and adoption in the United States has increased dramatically over the years and nearly 90% of the population had some form of dental insurance in 2022.³ Nonetheless, costs are still a barrier to accessing dental care for many, and even with insurance coverage, out-of-pocket costs can still present a challenge for people who want or need nonroutine care.⁴ As a result, patients will often defer treatment or seek more gradual ways to pay for their care to cover out-of-pocket costs.⁴

For patients seeking esthetic procedures such as implants or veneers, the cost of treatment can be an even greater barrier. These procedures are almost always considered to be cosmetic, and unless they are for restorative/reconstructive purposes, they are typically not covered by most insurance plans. Unfortunately, people who view costs as prohibitive to achieving a perfect smile may make care decisions based on what that they view as "budget friendly" instead of prioritizing other considerations.

Some people opt to pursue a healthy and beautiful smile through travel dentistry under the misguided notion that they could receive the same quality treatment at a lower cost.⁵ However, there are risks associated with receiving dental care abroad that can result in irreparable harm to patients' smiles and cost them substantially more to correct any damage that is done. According to the US Centers for Disease Control and Prevention, people who receive their dental care abroad may end up experiencing more complications than those who receive their care domestically for several reasons, including the following⁶:

·      Dentists or oral hygienists in other countries may not have or need the same certifications or years of experience required in the United States to perform the same procedures, which can lead to unsatisfactory outcomes and even medical complications.

·      Some patients might not allow for adequate time to heal or may become lax on their postoperative care when they are no longer able to see the doctor who performed the procedure.

·      For any treatment that involves a surgical procedure, such as implant placement or soft-tissue grafting, there is also an increased risk for serious infection if the site is not properly looked after.⁷

These factors can all lead to drastically worse oral health and potentially impact the overall health of patients in the event of infection. The goal of any healthcare providers, including dentists, is to ensure that all patients are receiving the best care possible, but standards of care can vary, and sometimes, costs that are "too good to be true" are just that.

So, what can be done to keep patients stateside knowing that costs may be difficult to navigate for people seeking any type of dental care? To start, take the time to gauge if patients actually need cosmetic dentistry or if there is a more affordable option that can achieve their goals. For example, if patients' concerns lie with the straightness of their teeth or the appearance of their gums, perhaps traditional orthodontic or periodontic care can suffice. These more traditional pathways may prove to be financially more manageable for patients because their insurance may in fact cover or at least partially cover such care.

In cosmetic dentistry, it is just as important as in traditional dentistry to work with patients to explore the different treatments available that might help them achieve their goals long term. In addition, it is important to emphasize to patients that proper dental care is an investment and that cutting corners may ultimately cause more problems for them. For patients who truly want to pursue cosmetic care, be it whitening or veneers or some other treatment, it is equally important that they are made aware of the financial options are available to help them manage the costs.

For those who are looking into crowns or implants, start the discussion with insurance coverage then delve into other options, such as health savings accounts/flexible spending accounts, federal/state assistance programs, and in-house or third-party membership or payment plans. Some patients may not know what payment or financing options are available to them, and learning about these options can result in them choosing to receive treatment at your practice.

For providers who don't offer an in-house plan or are looking to move away from in-house financing, offering third-party financing options can be an excellent solution to lessen some of the administrative burden and financial responsibility associated with financing-all while providing patients with the flexibility that they need to pay for care over time in budget-friendly ways. These third-party solutions, such as the CareCredit health and wellness credit card, may prove appealing to patients because they can seek dental care domestically in the United States without having to worry about paying for it up front.

Ultimately, it is in the best interest of patients to have their dental work performed correctly the first time and in a way that offers appropriate follow-up and long-term maintenance from a licensed and certified provider, especially for those seeking elective cosmetic treatment. To achieve this, dental providers should present treatment options that include both traditional and cosmetic approaches that have the potential to deliver the results that patients want as well as payment options that can put such treatments within their financial reach.

Brian Harris, DDS, is the creator of the Smile Virtual cosmetic teledentistry platform and the Klēn line of natural oral healthcare products. He maintains a private cosmetic dentistry practice in Phoenix, Arizona. Matt Muscolo is the senior vice president and general manager of dental practices for CareCredit.