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745: The 7 Steps to Move From Traditional Dentistry to Ideal Dentistry – Dr. Christian Coachman

Your practice may be great. But you can always make it better! To help your business improve and evolve, Kirk Behrendt brings back Dr. Christian Coachman, founder of Digital Smile Design, to talk about his upcoming DSD Provider course and to share seven steps to move toward ideal dentistry. To learn the best way to give your patients a better experience and better outcome, listen to Episode 745 of The Best Practices Show!

Learn More About Dr. Coachman:

Learn More About ACT Dental:

More Helpful Links for a Better Practice & a Better Life:

Main Takeaways:

  • Think broadly, big picture, and beyond your biased mindset.
  • Integrate interdisciplinary software and interdisciplinary thinking.
  • Empower visualization. Leverage 3D software and new technology.
  • Engage in collaborative, structured communication and decision-making.
  • Perform standardized, efficient, guided clinical execution for optimal results.
  • Find a digital lab to work with. They will help you diagnose, plan, and sell better.
  • Use imaging, technology, and communication skills to ethically onboard patients.
  • Improve your leadership skills to be a better leader. Ideal dentistry is a team sport.


“I like the word “ideal” because, first, I know I will never become ideal. We are never perfect, so it's the light at the end of the tunnel. It’s something that you want to always be moving towards. Even though you know you're never going to be perfect and you're never going to be ideal, it makes us move. I want to be closer to ideal. And I'm pretty sure that every good dentist with good intentions, every great clinician, ethical clinician — it doesn't matter how good you are. When you look at what you do, if you're humble enough to make this autoanalysis, you obviously conclude that there are always things [that can] be better, and there's something more ideal ahead of us.” (10:04—11:00)

“I strongly believe that it doesn't matter how good the dentist is, we are biased towards what we like to do the most. Usually, first appointments are completely biased towards our specialty. That's why dentists who are very good with veneers, all they do is veneers. On the first appointment, all they diagnose is usually veneers. Or the dentists that love aligners, all they do is aligners. All-on-4, All-on-X practices, they try to fit all the patients into that box, and all they do is All-on-X cases. If you are an occlusion expert, you only see the occlusion. And so, there's no problem being a super expert, a super specialist. I believe that modern dentistry deserves a first appointment — at least the first appointment — that is non-biased, that is generic, that is holistic, that is comprehensive. Because if the patient comes thinking that they need X, we as care providers need to see from A to Z. It doesn't matter — treatment plans can be different, but the diagnosis needs to be the same and needs to be similar, at least. It needs to be complete. Modern human beings deserve that.” (11:53—13:14)

“A super generalist is a professional that understands the minimum amount of everything that dentistry needs to know that impacts a human being from the physical, mental, and even spiritual perspective. So, it's understanding how to connect the dots. It's looking beyond the mouth. It's understanding the connection between the bite and the posture, the arch form and the airway, the mouth and the body, and everything else. We are so much at the beginning of this journey, and this journey is beautiful. So, the first step towards ideal dentistry is moving from this biased, superficial, partial mindset and data acquisition into a holistic, systemic mindset and data acquisition.” (13:30—14:28)

“In dentistry, software was not developed to help us treatment plan from an interdisciplinary perspective. So, software is all fragmented. They don't have the tools to allow us to actually use them before we know what to do. It's interesting. Software in dentistry was developed to be used after the dentist already knows exactly what to do. So, I know exactly that my patient needs six veneers. I'm going to use the software to manufacture the six veneers. I know exactly that my patient needs ortho. So, I'm going to use the software to manufacture my aligner. I know exactly that my patient needs two implants exactly in this position. I'm going to use the software to do the guides and the restoration of the implant on that position. The problem is that planning the execution is much easier than planning what my patient actually needs.” (16:20—17:19)

“Interdisciplinary dentistry is multifactorial, and every specialty impacts the other. As we move one side, you change everything else. So, it's very complex. It's very difficult to diagnose and treatment plan properly. That's why we see many more great clinicians than we see great diagnosticians. So, if diagnosing properly is the most difficult part of dentistry, we need technology that helps us in the most difficult part of dentistry. And it's funny because 99% of everything that was developed is focused on the execution and not on the diagnostics and planning. So, to move into the future, we need to push the industry to develop integrated interdisciplinary software. And, of course, that won't do the magic if we don't have integrated interdisciplinary thinking as well.” (17:26—18:22)

“Our education is also fragmented, and we learn to value the specialist and the super specialist. And then, you specialize more, and more, and more, and more. And the industry rewards the super specialist. We need to start rewarding the super generalist. The super generalist is a dentist that is above all super specialists. It's like a new specialty that needs to be above everybody. It's the profession that will perform the first appointments. It's that super-good, old-school family physician that when you were not feeling good and you didn't have a clue about what you had, you would go to this person. Ideal medicine should always start from this generalist that sees you as a whole, that understands everything, that will be able to raise the yellow flags and then, when necessary, activate the specialists.” (18:31—19:36)

“We need to empower visualization. Meaning, it makes no sense to not use images to understand the problem and create a solution. In dentistry, we make too many decisions without exploring visualization. We don't test drive our crazy ideas and we don't leverage 3D software to simulate our ideas. And the worst part, we don't communicate among the team with images. We try to explain problems with words. We try to create solutions with words, and it makes absolutely no sense with all the 3D technology that we have, and the technology to acquire visual information that we have today.” (20:54— 21:45)

“I always mention the iPhone in my courses. I say, ‘Look. In the last 20 years, the most impactful piece of technology in dentistry was the iPhone, more than anything else. Why? Because the smartphone allowed us to create visual content and to share and communicate based on the visual content at any second. It means that the whole world is connected through visual communication. If you have an issue and you think that people that were not there with you may help you with that issue, you can create the images to explain the issue and you can share that. And in a few minutes, a few hours, or maybe a few days, you're going to have amazing feedback — much higher-quality feedback — because people will understand better the problem because of the visualization. So, we need to learn how to transform our phones into the third eye of the other people that we want to help us.” (22:03—23:07)

“Move from individualistic and empiric decision-making to collaborative and structured communication and decision-making. So, it means that in dentistry, still today, because we don't learn communication systems and we don't implement them efficiently, we still do old-school communication. Meaning, having a coffee and talking to somebody, or even scheduling a Zoom call. These are all ways that are not efficient — on the phone or waiting until you meet the person to discuss the case. And because of all of that, too many decisions are made alone in dentistry. So, we don't leverage collective intelligence. Basically, [step] number four is leveraging collective intelligence. Collaborative and structured — structured because it cannot be casual. It cannot be unprofessional. It cannot be once in a while. It cannot be something that sometimes you do for some patients. No, it's something that needs to be for every single patient, every time.” (24:05—25:10)

“The most powerful strategy to make better decisions for your patient is to use visual and asynchronous communication systems that are professionally developed and implemented in a structured way so you can do it every single moment, every single minute of your life. You're always leveraging visual asynchronous communication. So, it needs to be a system that is almost like an auto-mode happening for you. Asynchronous means that you can talk to a group of people without having to be in the same place, available at the same time. That's the solution for our busy life. You cannot rely on synchronous communication.” (25:35— 26:20)

“It makes no sense to communicate dentistry without visuals. It’s like giving a dental lecture without slides. We need to use that for everyday patient and team communication, treatment planning, diagnosis, and live communication.” (29:22—29:37)

“With these integrated software, 3D visualization, and collaborative structured asynchronous communication, you can treatment plan a hundred times better, a hundred times more cases per month.” (29:51— 30:06)

“The fifth big movement from traditional dentistry to ideal dentistry is to move from non-guided, inefficient clinical execution to standardized, efficient, guided clinical execution. So, it's basically guided dentistry. I believe that in the near future, very few procedures in dentistry will be freehand because it makes total sense to use guides. Nowadays, it's so easy to simulate what you want on the software and design a guide in the software and print chairside the guide that will help your instrument, your hands, to follow the plan. It's very simple. Modern dentistry needs to follow the plan. We cannot have this discrepancy anymore between a diagnostic wax-up and an outcome of a treatment that are usually completely different. We need to bring them close together. So, we need to use everything we can to guide our hands to respect the plan.” (30:20—31:24)

“Many dentists still say guided dentistry is for beginners. That's not very smart to say because it doesn't matter how good you are. When you use guides, you respect the plan. And respecting the plan is a great story for the patient. One of the main reasons why I believe guided dentistry will have to become the future is because I believe that patients, when they learn about it, that's all they want. It's almost like if I'm a patient and I learn the advantages of guided dentistry, I will only go to a dentist that does that. I don't want to take risks. It's my mouth. It's my gums. It's my bone. Even though this dentist is saying that he's great and he has amazing hands, it's my gums. Don't cut my gum without a guide.” (32:10—33:02)

“[Step] number six is finding a real digital lab, or labs becoming the new version of a lab, the version that we call a modern lab that is basically a lab that becomes a planning center as well, a lab that will have not only the expertise to manufacture restorations, but it's a lab that will help dentists at the beginning of the journey: first appointment, second appointment, diagnosis, treatment planning, and selling. The three key words that we talk — diagnose, plan, and sell. If you want to grow in dentistry, master diagnose, plan, and sell. Everything will follow. These are the three magic words, and the lab should be your best partner to help you diagnose better, plan better, and sell better.” (35:01—35:50)

“[Step] number seven is how to move from weak educational tools, weak educational skills, and poor communication, to become a great spokesperson for yourself and a great spokesperson for your treatment plan. How do you defend your treatment plan the same way a lawyer defends their customer in court, defending all the points in a way that you win the case? How can you explain your treatment plan in a way that is beautiful, that is exciting, that is emotional? How can you leverage visual communication and storytelling when presenting a treatment plan? There's so much to explore. Of course, this is the key for financial growth in a practice. Of course, [steps] one to six needs to be under control first, because if you are a great persuader with low-quality dentistry, it's not ethical. So, you want to control one to six, but then you deserve the right to use your communication skills and use technology and visual communication to onboard the patient. So, we call it ethical patient onboarding.” (37:43—39:11)

“All of these ideas, I strongly believe, will become part of dentistry in a few years. But they are all only possible if you have a great team. So, I said the seven steps towards ideal dentistry. But there is an eighth, and that is leadership. It only happens through leadership because modern dentistry is a team sport. Ideal dentistry is a team sport. You need to build your dream team, and a dream team always has a great captain, a great leader. So, you need to ask yourself, are you willing to invest the energy to become a great leader, or do you prefer to join a team that already has a great leader?” (40:41—41:29)


0:00 Introduction.

2:28 About Dr. Coachman, DSD, and his DSD Provider course.

6:49 Find your spark in dentistry.

9:41 Step 1) Move beyond the biased mindset.

13:27 The super generalist, explained.

16:01 Step 2) Move into integrated, interdisciplinary software and thinking.

20:51 Step 3) Empower visualization.

21:45 Why image utilization is so low.

23:51 Step 4) Move to collaborative, structured communication and decision-making.

25:11 The value of asynchronous communication.

30:09 Step 5) Move into efficient, guided execution.

34:59 Step 6) Find a modern, digital lab.

37:27 Step 7) Engage in ethical patient onboarding.

39:13 More about Dr. Coachman’s online education platform.

40:28 Final thoughts.

41:31 More about DSD.

Dr. Christian Coachman Bio:

Combining his advanced skills, experience, and technology solutions, Dr. Christian Coachman pioneered the Digital Smile Design methodology and founded Digital Smile Design company (DSD). Since its inception, thousands of dentists worldwide have attended DSD courses and workshops, such as the renowned DSD Residency program.

Dr. Coachman is the developer of worldwide, well-known concepts such as the Digital Smile Design, the Pink Hybrid Implant Restoration, the Digital Planning Center, Emotional Dentistry, Interdisciplinary Treatment Simulation, and Digital Smile Donator. He regularly consults for dental industry companies, developing products, implementing concepts, and marketing strategies, such as the Facially Driven Digital Orthodontic Workflow developed in collaboration with Invisalign, Align Technology.