We must let our patients know what we diagnose even in the first visit. You may prefer to have a separate visit to show patients just what is going on in their mouths, and use the first visit as a gathering of information session. In the June JADA journal, Dr. Emily Ishkanian interprets the ADA code for us and notes that many of us are leery of presenting too much needed dentistry at the get go, and feel that a patient may not return. We as dentists feel that the patient thinks we are "looking to buy that new car, boat or lake house".

Have no fear, we do have alternatives.

Dr. Mike Kesner, one of dentistry's best consultants, advises to let the patient know that there are problems, but he suggests you laser focus on the worst problem, fix it and move to next.

Dr. Frank Spear and Dr. Kesner also believe that a three-step process works best.

1. Show the patient the problem.
   "Mrs. Jones, you have a cracked molar tooth as you can see in this picture of your tooth."
   
   
2. Discuss the consequences of non-treatment.
   "Just like a windshield, these cracks continue to grow due to the pressures of chewing. Not treating this tooth will eventually lead to the crack splitting the tooth necessitating its removal or a piece of tooth breaking off. Either way, it may happen on a weekend or evening when my team may not be able to help you with any pain resulting from it."
   
   
3. Tell them what their benefit will be if it is treated now.
   "Since you will need to treat this tooth at some point in your future, we can eliminate the need to remove the tooth and place an implant by completing a crown on that tooth at your earliest convenience."
   
   

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