Auckland 6 May

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Dr Mark HassedThis is the final notice about my upcoming seminar in Auckland on 6 May.

The seminar is the full day one (6 hours of CPD) — Master the Art of Case Acceptance.

If you live in New Zealand or have friends there keep this date in mind.

Click here to register.

There are only 3 places remaining and this will be my only Auckland seminar this year.

Building in contingencies

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Dr Mark HassedA while ago I was visiting a practice and there was a major screaming match going on at the front desk.

It turned out that the dentist had quoted $1,600 for a crown. During the preparation the old filling had come out and so the dentist had made a core. The dentist added $250 to the fee.

The patient felt cheated and rightly so in my view. They had been quoted one fee and at the front desk handed an account for a higher amount.

That leads me to an excellent rule to live by: Always quote high.

If you think an extraction might be a surgical quote for a 324. If you think a core might be needed add it to the quote. If you think a filling might need cusp coverage add it in.

You can always bring your fee down and patients are delighted when you do so.

But if you go up you risk a major negative incident with a patient.

When you prepare a quote do you always quote high?


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Attention all Kiwis! I seldom get to New Zealand so please don’t miss out on this opportunity.

Auckland 6 May – click here for details.

Empathy. Useful or not? (part 2)

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Dr Mark HassedA few weeks ago I wrote a post concerning empathy.

Empathy is the situation where you feel what the patient is feeling. My post took the view that empathy is useless and often harmful.

Here’s another reason empathy is harmful — it leads to minimisation. Dentists see a serious situation but they’re so worried about upsetting the patient that they send a weak, wishy-washy message. For example:

Instead of saying: “You have severe gum disease and if you don’t treat it you will lose your teeth” they say “Your gums are a bit soft.”

Instead of saying: “There’s a big hole between your back teeth” they say “You have a tiny spot of decay.”

Instead of saying: “You need to give up soft drink or you will destroy your teeth” they say “You need to cut down a little.”

There are many more examples I could give but I’m sure you get the idea.

Are you ever guilty of minimisation?

If so you might want to think about it. You’re not doing your patients any favours.


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Attention all Kiwis! I seldom get to New Zealand so please don’t miss out on this opportunity.

Auckland 6 May – click here for details.

Fear of rejection

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Dr Mark Hassed“The majority of dentistry is not completed because it was never presented.”
— L. D. Pankey

The more I talk with dentists at my case acceptance seminar the more I realise there is fear in the profession — many, perhaps most, dentists are terrified of rejection.

This fear shows itself by what the dentists choose to show patients.

Let’s say a patient attends with a broken tooth. You can say “I’ll fix that!” and then do a filling. This path has zero chance of the patient saying “no”.

Or, you can offer the patient a crown or onlay. Higher fee, but better, more long lasting restoration. But, if you do this, the patient might say “no” and just go with a filling.

If you have a very fragile ego this can lead to a feeling of rejection. You might feel bad for a while.

Many dentists get around this problem by giving their treatment suggestions in extremely vague language: “Mr Patient, you might perhaps want to one day consider thinking about looking at doing a crown on that tooth.”

By expressing the treatment option in this wishy washy fashion there is no chance of rejection because the patient doesn’t have a clue what you’re talking about.

Do you use words such as “think about”, “one day”, “perhaps” and “look at” because of your fear of rejection?


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Auckland 6 May – click here for details.

Empathy. Useful or not?

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Dr Mark HassedI had a very interesting and challenging conversation with a medical practitioner recently.

They held that the secret to good patient communication was empathy. They felt that without empathy you could not really help the patient.

I took the exact opposite view on empathy. I feel that empathy is at best useless and often harmful.

Empathy is defined as “the ability to understand and share the feelings of another”.

Here’s why I take a dim view of it.

  1. Patients are often full of fear and neuroses
    Why would I want to share fear and neuroses? An ideal dentist should look kind and understanding on the outside while remaining like teflon on the inside.
  2. Your job is to fix problems
    Problems are best solved if you remain detached and objective. The moment you become emotionally involved your judgment is clouded.
  3. Empathy wastes time
    Certainly you have to listen to and hear people but empathy often leads to prolonged wallowing in problems.

Where do you stand on empathy?

My recommendation is to be kind and considerate but keep internal detachment and impartiality.


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Sydney 8 April – click for details.

Auckland 6 May – click here for details.

Your patients are not different

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Dr Mark HassedIt’s an element of human nature that people find it very hard to admit mistakes.

There’s a famous book called “Mistakes were made (but not by me)“. In it the authors explain “why we justify foolish beliefs, bad decision and hurtful acts”.

Whenever I meet a dentist who is failing frequently in treatment discussions with patients they always have a reason why it’s not their fault:

  • “My patients can’t afford good treatment.”
  • “We’re in an area with low dental IQ.”
  • “My patients prefer extractions and dentures.” [What person in their right mind would prefer that?]
  • “I explain the 27 things that can go wrong with a root filling and after that the patient just wants the tooth out.”
  • “My patients are different.”

I hate to disillusion anyone but here is the truth: Your patients are not different.

Everywhere I have ever been people would rather keep their teeth. Also, people prefer good, long-lasting dentistry to short term patch ups. No exceptions.

The only reasons that people ever choose sub-optimal dentistry are either lack of understanding or lack of money. You can almost always fix the first reason and by staging treatment you can very often fix the second reason.

If you struggle with case acceptance or think that “my patients are different” then look at yourself and consider taking a course (dates are below).


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Sydney 8 April – click for details.

Auckland 6 May – click here for details.

Self sabotage

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Dr Mark HassedNear my last office I used to have two specialist oral surgeons — let’s call them Dr Alpha and Dr Beta.

When I’d send someone to Alpha for an implant they’d invariably come back a couple of months later with it in place ready for the restoration.

When I’d send someone to Beta they’d usually return having decided not to proceed with treatment. I wondered why.

It turned out that Beta was giving a long and very scary list of possible complications. So scary that only the most determined patients proceeded. Beta even warned of the possibility of death.

Over the past few years, I’ve noticed a trend among many dentists (especially young, inexperienced ones) to give patients a huge list of possible complications, even if the odds are only 0.0001%. They even give dire warnings about trivial, easily managed complications.

To me, it looks like a form of self sabotage where dentists are so terrified of failure that they try and dissuade patients from normal and reasonable treatment. They’d rather extract a saveable tooth than try to save it and fail.

I wonder how many saveable teeth are lost every year due to extravagant warnings by the dentist.

If you find yourself warning patients about 19 things prior to starting a root filling ask yourself: “Am I doing this for a sensible reason or am I doing this because of my lack of competence or because of my personal fear of failure?”

Disclaimer: Despite all of the above, you must do whatever your dental insurer says.


DentistThe Art of Case Acceptance is on again.

Learn how to get patients to accept the treatment they need.

Sydney 8 April – click for details.

Auckland 6 May – click here for details.