The Curious Question



Curiosity may be dangerous to cats, but it can be a lifesaver for the dentist/patient relationship. Simply put, curiosity can inspire questions that have the potential to transform your practice from an ordinary one into an extraordinary one.

In the 37-plus years that I have been going to the dentist, I can’t remember ever being asked questions beyond the usual, “What brings you in?” or “Any tooth pain?”

Most of my interactions with the dentist have been limited to a few exchanges as he or she checked my teeth after a cleaning and then remarked, “Everything looks good! We’ll see you in six months.”

While there’s nothing wrong with asking basic questions, consider taking the time to ask patients about what they want from their smile. Frankly, until I started working in the dental field, I wasn’t aware that much could be expected from my smile beyond an occasional cleaning or bleaching.

Unfortunately, my experience is not unique. Dentistry has the potential to change patients’ lives for the better. But many patients don’t experience that kind of dentistry.

Most patients are unaware of the confidence-restoring power of a full arch reconstruction. They have no idea that simple occlusion therapies may help them live a life free from chronic headaches.

A reason they don’t understand dentistry’s full potential is because it is often not effectively communicated; dentists and others sometimes fail to educate patients about the possibilities available. Educating patients doesn’t need to be complicated. Simply ask a few probing questions.

One of the most powerful questions a dentist can ask is, “How do you feel about your teeth and their appearance?” The question is great because it requires patients to articulate their expectations, questions, concerns, and experience. In doing so, dentists gain insights at a surprisingly deep level, regarding what the patient values and what motivates them.

Why would dentists short-change themselves by neglecting to ask such a simple question? The primary cause may be due to dentists making assumptions about what the patient wants or can afford. How often do dentists assume that their patients only want what insurance will cover?

I began asking acquaintances outside of the dental industry about their experiences. Did their dentist ever ask in-depth questions about their smiles or their dental goals? Like a health goal, a dental goal helps patients overcome issues (such as grinding teeth or fixing a cosmetic imperfection) that they may not have known was possible.

Without fail, every person I queried had the same response—no, they had never been asked detailed questions about their smile. And as far as their dental goals, they all assumed I was asking if they had their six-month cleaning appointment scheduled.

Although my ad hoc questions do not constitute a statistically significant sample, it hints at what could either be a huge problem or a huge opportunity, depending on your point of view.

The Assumption Problem
In the book entitled, 3 Off the Tee: Targeting Success, author Lorii Meyers wrote, “Don’t build roadblocks out of assumptions.”

One of the biggest mistakes people can make is to assume they have a solid understanding of a customer’s expectations or desired experience. In business, this is called a customer bias and it is behind some of the biggest business failures of all time.

A classic example of customer bias is the “New Coke” disaster of the 1980s. In 1985, The Coca-Cola Company reformulated its signature product to taste more like its biggest competitor (Pepsi). A loud and immediate backlash soon followed, as customers and newspapers ridiculed the new formulation.

The Coca-Cola Company clearly misunderstood what a significant number of their customers wanted. Three months after introducing New Coke, the company returned to the old formula.

In dentistry, our are patients are our “customers,” and the same rule applies: dental professionals should keep assumptions from becoming roadblocks to life-changing dentistry.

Because some patients respond to case presentations with, “I only want what insurance will cover,” many dentists eventually give up presenting large-case options.

In order to avoid this problem, dentists should supplant the assumptive patient interaction with one that is instigated by curiosity. Consider asking questions like, “What do you like most about your smile?” or “What do you like least about your smile?” and listen to how the patient responds.

Afterwards, you will get a better understanding of a patient’s circumstances and what he or she values. With this understanding, a dentist is in a better position to offer patients what they want. It expands opportunities for the patient and dentist alike.

The assumption problem is pervasive because for most people, it’s automatic. Although assumptions may appear to save time, they shortcut interactions that lead to health-promoting procedures for the patient and potential professional opportunities for the dentist.

In dentistry, such assumptions usually take two basic forms: first (as noted previously), dentists focus on presenting treatment options that they feel the patient is likely to accept or can afford rather than the optimal course of treatment.

Second, dentists present treatment options in a way that is representative of a limited perspective. For example, I know a dentist who told a patient that he just needed to have some veneers added to address some cosmetic issues. The doctor didn’t ask the patient about what additional considerations there might be—functional problems, headaches associated with malocclusion, or anything else.

The result is that often patients are robbed of the opportunity to understand and experience the highest quality of treatment available, and dentists are robbed of the opportunity to provide that kind of dentistry.

Turn On the Curiosity
How do dentists move beyond the basic questions to provide more for their patients? My advice is to turn off what I call the G.P.S. or “general patient spiel”—those common, repetitive phrases used by healthcare professionals that include, “Everything looks good! We’ll see you in six months.”

Turning on curiosity is as simple as making sure that your patient interactions involve questions that are designed to explore their experiences and expectations. A simple way to do it is to follow an approach that Dr. Dick Barnes espouses, in which the doctor and the patient sit “eye to eye and knee to knee.”

Here’s a scenario of what that interaction might look like:
Doctor: [Patient Name] In order to be able to deliver the best care that dentistry can offer, it’s important that I understand what your expectations and goals are for your oral health.
Patient: I’m not sure I know what you mean.
Doctor: Well, how do you feel about your teeth and their appearance?
Patient: I think my teeth are pretty healthy and they seem to work without much trouble. There are a few things I would change if I could afford it, but nothing that I feel is really a problem.
Doctor: [Patient Name] I am glad to see that you take your oral health so seriously. As your dentist, I am concerned with offering the best options and outcomes that dentistry can provide. Let’s do this, putting cost considerations aside, tell me about what you would like to change, so that I can better understand what you are thinking.
Patient: Well, I have noticed that my two front teeth seem slightly worn down. It isn’t painful or anything but it is something that I notice when I look in the mirror. I think it stems from when I was in graduate school—my wife told me that often (especially when I get stressed), I grind my teeth at night. Since that time, I have been using one of those nightguards from the pharmacy.

In this short interaction, the patient provides a large amount of information. First, the patient shares that the perceived cost for dental care is a concern. This information is invaluable because it allows the doctor to effectively engage on that topic during the case presentation.

Second, the patient shares a minor aesthetic concern that could have much broader implications. The minor wear on the front teeth could be due to an occlusion or sleep apnea problem that might be causing other problems like migraines, fatigue, or TMD issues. The fact that the patient is already self-treating through the use of a consumer-grade mouthguard indicates an awareness of the problem and an interest in doing something about it.

With this information, the dentist can ask very focused follow-up questions to better identify the full scope of the issue. If, for example, the dentist discovers an occlusion problem that causes chronic headaches for the patient, this is a huge opportunity to deliver a solution that would have a deep impact on the patient’s quality of life. The patient’s experience with dentistry, and the care and attention they feel from their dentist would be greatly enhanced.

The question, “How do you feel about your teeth and their appearance?” asks patients to consider both the functional and aesthetic aspects of their smile. Too often, problems rather than possibilities are the focus of most dentist/patient interactions. As such, the full potential of what can be done is not fully explored or explained. Such interactions leave the patient unaware of dentistry’s possibilities.

Lastly, for dentists who are more introverted and less comfortable engaging with patients in this type of conversation, the question is great at quickly eliciting details on which effective follow-up questions can easily be asked.

Once a dentist asks the question, the information is worth its weight in gold. If you understand a patient’s motivation and what they value, creating a case presentation that delivers true lifestyle improvement becomes much easier.

There has never been a better time to be a dentist. The wide array of treatment options ranging from dental implants to sleep dentistry and full mouth reconstruction, means that you have the solutions your patients want—but they need to understand that you care before they can understand what amazing solutions modern dentistry can provide.

Had any of my previous dentists been curious about what I wanted or needed, it could have opened my eyes to dentistry’s amazing potential at a much earlier time.

Remember, let curiosity guide your interactions so you can help your patients discover the many incredible options that are available. If you never ask anything, you’ll never know what you and your patients may be missing out on.

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Matthew Cook has been a dental technology consultant for more than eighteen years, specializing in the creation of technology-enhanced business processes. In 2004, he joined Arrowhead Dental Laboratory as the head of their IT Department.


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