Smile designing for the malcontent patient.

Patients and dentists may have conflicting opinions regarding the definition of an esthetically pleasing smile. Every dentist is likely to encounter malcontent patients who may have difficulty communicating their esthetic desires for smiles and may even refuse to pay for successful treatment outcomes that they misperceive as failures. Learning how to work with such patients is essential. Part of achieving patient satisfaction is encouraging their participation in designing their smile. With the use of a crown-bridge-veneer pattern, tried-on prepared teeth, or implants, an exacting acrylic wax smile is designed. This pattern is used to analytically and objectively design porcelain contours for the finished smile design. This technique works well for veneers, full crowns, or bridges.