Occlusal Splint as a Tool of Persuasion


Many dentists are under the impression that presentation is a specific, isolated procedure.  In my new book I make


the very important point that presentation is not a system or a’s an approach.  Through over the 200 plus pages of the book I continually make that point.

Recently, a new patient entered my practice.  She found me on the Internet (through a piece of the Art of Presentation known as Cyberbranding, that is discussed in the book).  Her chief complaint was discomfort–sore muscles to be specific).  Her bigger problem was that she had a failing 6 unit upper anterior bridge.

She has a dentist.

Her dentist was in the process of making her a new provisional when she told him of her discomfort.  He told her to get that fixed first…but he never referred her…so she found me…by Googling…TMJ specialist…and my name came up #1.

But it’s here where the real adventure begins.

She has a dentist.  She trusts her dentist.  Her intuition told her to stop and get the TMJ problem solved first.

My job…is to take very specific information that I will gather up in a comprehensive examination, and find a way to explain it to her, in a way that makes sense to her.  Along the way  I find many bumps in the road…mostly centered around trust and money.  My first bump is explaining the need for the complete examination.

She said she had radiographs taken recently.  She brought them with her.  Bitewings and a few periapicals revealing the failing terminal abutment of the bridge.

Within a few minutes, by addressing her chief complaint (pain) and relating it to the musculature (by showing her the relationship of muscle contraction and canine guidance…my masseter shuts down while her’s continues to fire), she sees some light.

John Kotter in his book, The Heart of Change, describes the most effective way to persuade people is to use a method he calls See, Believe, Do.  That’s what I did…showed her.  She then believed me and she did the exam.

It’s that quick.  But I still didn’t relieve her pain…just her confusion.

The next step is to prescribe splint therapy.  This takes time.  She’s already told the other dentist to halt the provisional until she gets comfortable.

I know the splint will work.  I’ve made a few in my time.  The more difficult part of this case is to change her thinking…change her beliefs about dentistry…see, believe, do.

The splint will do that.  No pictures of beautiful cosmetic dentistry of how she will look.  No convincing her of how good my work is or that I am an artist.  No photography.

So by showing her the care she was looking for by attending to her chief complaint, and by by providing her with a solution that will actually relieve the pain she can then go forward and address her bigger long term issue...because I exhibited care and competence…the two components of TRUST.

And the splint is the major behavioral tool of change.

There are many lessons here:

1. A confused mind always says no.  That’s why she sought a second opinion.

2.Make the art of explanation a priority.

3. Understand occlusion as a key to opening the door to your more technical skills.

4.  Slow down…build trust.  With people, as Covey says, fast is slow and slow is fast.

These are the lessons I learned through the years at the Pankey Institute, the Dawson Academy and Spear Institute.  Tough lessons with huge payoffs.

The future of dentistry belongs to those who get it…for the others who want to know the next generation of bonding agents or what is the benefit of platform switching….Google it.













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Selling S***t No One Wants to Buy



Dachshund puppies

In my forty years of practicing dentistry I never had the opportunity to tell a patient, “It’s a boy!”

“You need a root canal,” aren’t the words that most people want to hear.  There’s a reason why comedians have picked on dentists for years.  If I hear the root canal metaphor one more time it won’t be too soon.

Persuading people to get their teeth fixed is a bit more difficult than selling cars or puppies.  I know…I sell puppies.  People come looking and they always leave a deposit.  I wish my front desk had it so easy.

There’s a reason sales professionals created something called the “puppy dog close.”

The closest thing we have to a puppy dog close is the trial smile, or cosmetic mock up.  But we can’t tell the patient to take it home for the weekend like a beautiful puppy.  A photo will have to do.

I can discuss needs vs. wants till the cows come home but the problem, as I see it, it’s what Avram King expressed years ago when he said you want your patients to be paying with “happy dollars.”

I really think this was the reason why the cosmetic dentistry revolution started.  Dentists realize that complete dentistry is a tough sell, what with all the objections, so they grabbed onto the most obvious visible benefit.

But esthetics shouldn’t be the driving force behind dentistry.  Hiding beyond the idea that everyone wants a beautiful smile (well, not everyone), is that everyone wants to keep their teeth (yes, everyone).

Strangely, not everyone likes dogs, but even still puppies are quite persuasive.  It’s a 55 billion dollar per year industry.

So how do dentists fulfill their obligation to help people keep their teeth?  Yes, I do believe it’s an obligation and if you are a dentist reading this, and you have other thoughts, I would like to hear from you.

It starts with leadership.   It really is about becoming the change you want to see in the world.  That is why I wrote my new book The Art of Case teach dentists there is no way of closing someone on keeping their teeth.  No gimmicks, no manipulative tricks.  Case presentation, persuasion, and leadership are all one.  An approach to practice and life.

Persuading patients to lose weight, stop smoking or get their teeth fixed will never be as easy as persuading them to take one of those dachshunds home…but that’s part of our job.  If we can do that- then  just like Sinatra said about New York—“if you can make it there, you can make it anywhere.”

For a short time I will be offering the Art of Case Presentation at a 25% discount by clicking on the ADL Newsletter sign up button.








The Real Key to Influence



There are many books dentists can read to get better at presentation.  Most of the books can be found in the Sales and Marketing section of your local bookstore.  It seems that over the years I have read most of them.  Add to those the numerous books on philosophy and psychology and I could write my own book.  Hmm…I already have.

But in all seriousness, one book that was recommended to me years ago by Dr. Peter Dawson was S.P.I.N. Selling by Neil Rackham.

Great book…lots of practical information, but like so many books it falls short on specific advice for my day to day experiences with patients.

Let me give you an example.

S.P.I.N. is a process or series of questions that guides your patient interview.  It starts with Situation questions, Problem questions, Implication questions and finally Need payoff questions.

Essentially it is a guide to uncover the patient’s real problems and for you to fit that problem with your solution (payoff).

The real crux of Rackham’s system comes with finding the right implications.  In other words—what’s the real meaning behind the problem?

This is what most sales trainers call the WIIFM part of the presentation…the benefit.  And this is what they used to call in the Bronx…what separates the men from the boys.

The very best have a way of drilling down to uncover the real problems and their emotional implications.  Most of us have heard the sales saying, “People buy on emotion and justify on logic.”

Well the very best understand that and always think in terms of implications.

For example, I had a patient who resisted getting her front tooth fixed until her husband refused to go out in public with her anymore.  Fix the tooth for health reasons?  For functional reasons?  For comfort and appearance?

No way.

But when the idea of not being accepted came up…she was in my office in a New York minute (second reference to the Big Apple).

Yes sitting high up on Maslow’s Hierarchy of Needs is that need to belong.

It is their own particular circumstances and their own story that we need to explore in order to find what moves them.  That is why I advocate a complete examination that focuses on knowing our patients.

As a coach I hear stories like these all the time…specific incidents where the dentist says: “What do you say when they don’t see the problem, or when they tell you this objection or that.”

I tell them there are no words…just a mindset which includes lots of empathy and thinking about emotional implications.

Think in terms of implications — be preventive, so your patients don’t leave with regrets—“I could have had a V-8.”

 In the comments below—leave some specific situations where thinking in the language of emotional implication has helped you or created frustration.

In my next blog post I will give you an example of “selling ideas” rather than dentistry that just might improve your relationship with your laboratory.

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I Saved His Teeth —No Drill




Ralph had a dilemma.  He was in severe pain and had lots of dental fear and “no money.”  But he wanted to save his teeth.  I guess that’s more like a tri-lemma or a quad-lemma.  According to the dictionary, a lemma is a premise or a theory.  Ralph had three or four premises working against each other.  Anyway, he was not happy when I first met him.

Have you met many Ralph’s in your practice?  I guess so.  One thing about these issues – pain always wins.  Pain beats fear, pain beats money and pain beats time.

This is a moment of truth…not for the patient, but for the dentist.  Let me explain.

Most dentists, when a new patient arrives, look at the patient’s mouth and see a final result.  Their vision of a beautiful smile overcomes them and they start presenting dentistry, either in a positive or negative way.  But the dentist who is concerned with real change, and making a real difference will step inside the shoes of the patient and see the world from their point of view.

Ralph has been unemployed for three years.  His financial picture looks bleak.  Through further conversation we come to find out that Ralph said he had “no money” and he was jobless…but he has a home and a wife who works.  This doesn’t make him Rockefeller but he still wants to keep his teeth.

So what does Ralph really need?

If you said a plan, you are right.  Ralph needs a long-term plan.  A long term treatment plan that will take into account his financial circumstances.

This may sound obvious, but I don’t think it is common practice.  Creating plans and having in depth discussions are not what many dentists enjoy doing.  They like to fix teeth.

Yet…the real “art” of dentistry lies in the ability of the professional to effect real change.  That’s what artists do—they create—they create change.

Too many dentists think the art of dentistry lies in their veneers or their bonding.  I disagree.  Dentists call themselves artists…yes, even patients refer to them as artists, when most dentistry isn’t art at all.

When I ask dentists how they can be more creative in their practices, I mostly get blank stares.

Today, I used the Art of Examination and the Art of Case Presentation to help Ralph make a decision.  A first step.  That is not what he woke up thinking this morning…and I made those changes…created that change without picking up my drill.







Do You Scare Your Patients?



Many years ago, as a young dentist, at a study club meeting I heard a dentist say he gets patients to accept treatment by “gloomin and doomin em.”  That never sat well with me…I just knew it was wrong.

Still, I think, many dentists gloom and doom their patients.  Not intentionally as was prescribed, but more out of habit or even frustration.  One of the things dentists need to do is to stay optimistic.  Not only for their own survival but also for their patient’s ability to make healthy choices.

There is so much negativity around dentistry.  It costs too much, it hurts, it takes so long…we all know what patients tell us.  Not real good for morale.  So when the dentists adds doom and gloom to the mix, that only makes it worse.

Leaders close emotional gaps.  In the case of dentistry our job is to bring patients from where they are to where they could be.  That’s the gap. 

Not the intellectual gap but the emotional gap.

Too many dentists are like Jack Webb, the police sergeant on the old TV show, Dragnet.  They just give patients the facts.  Webb’s character, Sergeant Friday  was famous for saying, “Just the facts mam, just the facts.”

Well, dentists aren’t cops and we don’t enforce the law.  I like author, E.M. Forster’s classic lesson on story:   “The king died, and then the queen died vs. The king died and then the queen died…from grief.”

See the difference between that and “Just the facts mam?”

Abe Maslow told us that people are motivated by fulfilling needs.  Four of those needs are self-interest, self-actualization, belonging and hope for a positive future.

The job of a dentist is to close that emotional gap by painting pictures of positive, hopeful futures.  Our role is to motivate and lead…or else our role is that of a tooth mechanic or a repairman.

The entire profession needs to see the dentist’s role as one of leadership.  Only then will the profession shed the negativity associated with dentistry.

Is there any time I use gloom and doom?

Not really…but sometimes I use “shock” to get someone’s attention…but that’s another story.


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5 Deadly Sins of Case Presentation

Avoid These 5

Avoid These 5



Becoming a great presenter is a requirement for leadership.  Avoiding the 5 deadly sins of presentation is one step in the right direction toward becoming a leader.

I find that dentists commit these sins on a routine basis, and in this age of mega-information it behooves dentists to get their point across as fast and effectively as possible.

                        1. No Clear Objective.  Many dentists just present from the hip without thinking about what action they want the patient to take.  It’s a good idea to write down exactly what you want the patient to do as a result of your presentation.  This will serve two purposes…you will know if you are successful and it will keep you focused during the presentation.


                      2. The Presentation is Too Long.  Case presentations or any presentation shouldn’t take longer than 20 minutes.  It’s way too much information for anyone to digest.  When you are focused on the action you want the patient to take, then you will present only what is necessary for them to make a decision.  If you see their eyes glazing over…you have lost them.


                      3. No Benefit.  People will accept treatment when they understand the benefits.  Usually those benefits are emotional.  Don’t present the features of the work you are going to do…just tell them WIIFM (What’s in it for them).


                      4. Too Detailed.  It took a long time for you to get through dental school.  Now it’s time to condense that education into a succinct understandable presentation…not a lecture.  Albert Einstein said, “If you can’t explain it simply, you don’t understand it well enough.”


                      5. No Clear Flow.  Find a way to organize your presentation…the best way is to use story as your structure.  My new book The Art of Case Presentation explains how to structure presentations with story.


Prepare your next presentation avoiding these mistakes and observe how much better you do…remember the objective.






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Can You Use a Relationship Drug?




I don’t mind talking about dentistry…anywhere, anytime.  So, when a friend approached me in the gym and asked how business was, I told him, “It’s been slow.”  He then felt compelled to tell me, “Well, if you guys would lower your fees, you’d get more business,” as I stared at the gap in his smile that he never fixed.

Funny how people reduce complex problems down to a simple cause.  Most people can’t live with the idea of unsolved complex problems.  The answer to getting more business into a dental practice is not to simply lower fees.

But I love to talk dentistry, so I told him a story.

I asked him to imagine a dental experiment in which a dentist did the exact same procedure on ten different patients.  Let’s say it was a simple single surface filling on a lower molar.  He was following me because he was familiar with the terms filling and molar.  I didn’t want to confuse him, and I didn’t know how much dentistry he knew.

The procedure, I told him, required an injection, some drilling and then putting in the filling.  He nodded.  Then I asked him, “Do you think the procedure would be exactly the same for each patient?”

He gave me an understanding look…he was a master of the obvious.  He said, “No, each patient was different.”

“Yes, some would move, some would cry, some would scream, some would salivate too much…the variables are endless…and those ten scenarios only included the patients who made it for their appointed time,” I said.

Once again, full comprehension.

So I asked, should the fee be different for each one?

Now he looked baffled…actually upset, stymied, dumbfounded.  No answer.

I felt sorry for him, because my intention is to educate not aggravate, so I proposed a different solution:

“What if the dentist added a drug to the Novocaine that filled each patient with a high level of trust…love almost.  A strong feeling of attachment was created by this drug.”

He laughed and said, “Sure…can’t ever happen.”

“What if I told you that the drug already exists…and actually we humans can create our own.”

I had his attention.

“It’s called oxytocin.  It’s a hormone and a neurotransmitter (was pushing it with this word) that women secrete during childbirth.  I even use it as a dog breeder to help the girls give birth and start lactation.  It’s been called the hormone of love.”

He was wondering where I was going with this, so he said, “Why don’t you guys use it?”

“Because it’s not available here in the U.S.  The Swiss have a version that’s inhalable.  But we really don’t need it.  Recent research shows that if a person feels that they are around someone or something that expresses love, trust or the desire to bond, then their levels of oxytocin increase.  In other words we can manufacturer it ourselves.”

“So what good does that do us,” he said.

“Well, if there wasn’t all of this distrust in our culture, if there wasn’t so much self-interest going on, if people , including dentists didn’t worry so much about getting theirs, well, that would be a solution.”

“When pigs fly, ” he said.

Not really, if each of us takes the responsibility to really care about the other…things will change.  If not, capitalism in health care will need more and more regulation.  Or we can just lower our fees.

 By the way this conversation was a presentation of sorts…can you see why?




When a Dentist Gets Writers Block

overcoming writer's block - crumpled paper on ...

Overcoming writer’s block – crumpled paper on wooden floor – crushed paper


Do dentists see themselves as creatives?  I don’t mean mean dentists who write or paint…but rather in their everyday practice of dentistry.  It is my belief that people bring creativity to their job…and dentists are no exception.

In many ways dentists are like writers.  Let me explain.

Years ago, before I created my examination process, I would gather up all of the information from the clinical examination:  the radiographs, the models and the charts.  These days I have added study models and photographs.  Either way, I would sit down at my desk, get a cup of coffee, close the door and get ready to create my plan.  Sometimes I gave thanks that there wasn’t much to do…a simple case.  Other times, especially when the amount of material I collected seemed overwhelming and confusing,  I would sip my coffee and look blankly at the viewbox.  I would pick up the models, and many times nothing came to me.

It was the same feeling I would get when I get writer’s block.  Brainfog.

There are many ways to cure writer’s block, like going out for a walk and coming back later, but when you’re facing a deadline you have to produce something.  When a reporter gets writer’s block he just writes a bad article.  When a dentist gets writer’s block he creates a bad treatment plan.

Writers use outlines and other techniques like freewriting to create ideas.  Mind maps work well too.

One thing I always rely on is a guide.  When I sit down to write, I always put three words on top of the page: Topic, Angle and Purpose.  Those three words keep me focused.

I am a big believer in using guides.  When I create a presentation…I always use guides.

When I treatment plan I also use guides.  My treatment planning guide always sits out on my desk while creating treatment plans.  It has become a habit, regardless of the simplicity or complexity of the case.  For me it was about avoiding the brainfog of writer’s block.  And guess what?  My treatment plans make more sense.

I became more confident in my treatment planning process…because I actually had a coherent thought process.

This may sound obvious to many dentists, but what I have found out is that most dentists don’t work with a process.  They don’t have an examination process, a treatment planning process or a case presentation process.  Many operate by the seat of their pants.

It’s funny but some writers actually like writing by the seat of their pants, without guides or outlines.  It works well for them.  It works because they have erasers on their pencils…they can revise.

Dentists don’t get second chances.  Your Treatment plans are your gift to your patients…your creativity.

If you would like a free copy of my guide, become a subscriber to the ADL Newsletter.  As a bonus I will be sending out the many ways I use it to put my treatment plans together.  For those familiar with the Art of the Examination this is new information that I never wrote about in that book.

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Dental Treatment Planning Guide.






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Why Dentistry Will Never Get It



Many years ago dentistry was a simple profession.  Patients came in to get their teeth fixed, filled or cleaned.  Occasionally they would get their whole mouths fixed up.  And sometimes just get a tooth pulled.  And things were pretty much cash and carry.

Most people stayed with their dentist for years.  The family dentist was like the family doctor or lawyer or accountant.  Ahh, life was so simple back then.

images-2A lot has changed.  And a lot hasn’t changed.

As the world and industries change, the requirements of jobs change.

The cost of dentistry has skyrocketed.  That is not a complaint, everything goes up especially wages.  Those who watch the economy notice that prices have far exceeded wages.

With those economic changes have come cultural changes like the growth of dental insurance, and the loosening restrictions on advertising professionals.

Then there was the cosmetic dentistry revolution of the nineties when everyone wanted their teeth whitened but not necessarily fixed.

And dentists began to feel the heat.  They didn’t do as well as when times were much simpler.

But some still thrived…a minority who understand that when times get tough it’s time for a new strategy.  But most of dentistry doesn’t understand what that strategy should center on.


But here’s the rub…most of us think we’re really good at relationships.  So most of the continuing education dollars are spent on how to place implants and veneers rather than how to build trust.

We learn how to build complex 4 on 4 cases that we rarely get to do because we haven’t learned how to build the trust to make it happen…consistently.

Most dentists don’t have coaches.  Not mentors or teachers, but coaches.  A coach is someone who observes the way they practice and provides feedback through critique and correction.

Most dentists get cases accepted and never really understand what they did right…or wrong.  If they get to do many large cases they chalk it up to the halo effect.

Wikipedia defines the halo effect or error as a cognitive bias in which one’s judgments of a person’s character can be influenced by one’s overall impression of him or her.  In other words one gets credit for being a great communicator when really they are just a good dentist.

So, why won’t dentists get this, and why will organized dentistry continue to change so that only the very astute will be able to thrive and do the cases they love?

Because it takes a lot of humility to admit we need help in these interpersonal skills.  We must lose the arrogance that tells us we are master communicators.

We must ask ourselves what skills are essential for doing, actually doing great dentistry consistently?

We must be willing to be coached.

We must take ownership of understanding our own present skill levels.

We must truly understand what makes a great dental professional.

I think it’s humility!




What Does Dentistry Have in Common With Baseball Part II



In my last post on this blog I made the comparison of creating discipline in hitting a baseball with examining and communicating with patients.  Soon afterward  dentist-friend wrote me that the analogy can include staff as well.

I agreed.

I reminded him of another post I wrote concerning our definition of placing people above or below the line, and how we have a tendency to judge things as either this way or that way. 

I don’t know about you but dentistry has certainly changed over the past forty years, and our approach must change with the times.  There certainly was a time when my “boundaries” were a lot tighter than they are today.  To use a baseball analogy again, I see a lot more curve balls and cutters these days.

 Anyone can hit a fastball.

When it comes to patients my philosophy is to meet people where they are.

Of course, that doesn’t mean I have to bend my rules and change my policies to accommodate them…I just have to have more patience and more discipline.

I meet so many dentists who use phrases like “oh, that patient has no value for what I’m trying to do, maybe this isn’t the practice for them.”

Nice thought to discuss over a Miller Lite, but in this economy, where patients really need deep communication I like the approach to give them more of a chance.

I am seeing four patients at the present time that are in their late twenties, very poor dentition and personal circumstances that almost prohibit complete dentistry.  All have accepted care…and I am confident that when things get better, I will have played a big role in their lives.

The role of a mentor, a teacher. 

Taking time to understand them and build trust is the key.  I have written blog posts about motivating rather than educating…I want to quote myself, and hopefully you will quote me as well:  “You don’t have to know how The Force works, you just have to trust it.”

Patients, staff members who don’t trust the “force” have no place in a relationship with me.  I am quite sensitive to that…it never seems to work out in the long run.

Too many dentists are too quick to pull the trigger and tell a patient that this isn’t the practice for them.  Maybe it’s not.  Certainly, I have behaviors (boundaries) I won’t tolerate, we all know what those are.

So many of these patients are looking for someone who will work with them.  When our focus becomes one of growing people, we will grow along with them.

The guy down the street can’t do it any better than you.  Or any cheaper.




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