How do you manage patients that have ultra high expectations?

What’s the best way to communicate cosmetic outcomes before the final result?

How do you balance your aesthetic vision with what they see?

Dr. Brandon Mack joins Jaz for a deep dive into the realities of cosmetic dentistry—from subjective perceptions of beauty to practical tips that make or break a case.

They discuss how to navigate aesthetic stress, manage patient expectations, and even go into Brandon’s favorite veneer cement and occlusal philosophy. Plus, Brandon shares key failures that shaped his journey—and how you can avoid the same pitfalls.

Protrusive Dental Pearl: When discussing smile design with patients, especially in high-end cosmetic cases, set the right expectations early by using this memorable “Eyebrow Analogy”:

• Central incisors = Twins (they should be as symmetrical as possible)
• Lateral incisors = Sisters (not identical, but related)
• Canines = Cousins (more individual)

This helps patients understand that perfect symmetry isn’t always natural or necessary — especially for lateral incisors!

Key Takeaways

• Cosmetic dentistry as a lens through which all treatment should be approached—balancing patient autonomy with ethical care.
• Managing expectations begins before the patient sits in the chair. It continues through structured checkpoints: from initial consultation to provisional feedback and final delivery.
• Temps aren’t just placeholders—they are test drives. They align expectations between the dentist, patient, and lab, reducing surprises and improving satisfaction.
• Some dentists may under-diagnose due to fear of rejection—not out of true minimalism. Thoughtful planning can make “more treatment” actually less invasive.
• Patients often want teeth that are both ultra-white and natural-looking. Brandon developed the concept of believability—a visual balance that delivers a wow-factor while still appearing real.
• Creating a mathematically perfect smile can make natural facial asymmetries more obvious. Dentists must weigh beauty against harmony.
• Social media and filters have distorted patient self-perception. Dentists must learn to identify signs of body or tooth dysmorphia and respond ethically—not just clinically.
• Building relationships with ceramists over time—expecting 15–20 cases before finding synergy. Each technician has unique strengths and should be matched accordingly.
• Composite veneers are accessible and beautiful—but extremely technique-sensitive. You become the ceramist. Brandon admires them but uses them selectively due to long-term maintenance concerns.
• Panavia Veneer Cement – Translucent for its predictable handling, strength, and minimal risk to thin ceramic restorations.

Highlights of this episode:

• 01:35  Protrusive Dental Pearl
• 03:11 Dr. Brandon Mack’s Journey and Philosophy
• 09:19 Managing Patient Expectations in Cosmetic Dentistry
• 14:23 Choosing the Right Technician
• 21:13 “Undersell and Overdeliver” Philosophy
• 25:12 Conservatism in Cosmetic Dentistry
• 26:48 Overcoming Failures
• 33:15 Body Dysmorphia in Dentistry
• 37:28 Occlusal Philosophy and Techniques
• 38:30 Fake It Till You Make It?
• 40:38 Veneer Cement 
• 42:07 Composite Veneers
• 44:17 Upcoming London Event and Final Thoughts