Spend 15 seconds on 90% of dentist-driven Instagram pages and you can't miss the push for big-case dentistry. For some, it's veneers. For some, it's all-on-X. For some, the lure is fame. For others, the lure is fortune. Either way, as a new dentist, your ability to know if and what big-case dentistry is for you in 2025 will make or break your reputation and wallet.
Why not to focus on it
I'm going to caveat this section with this: 30 years into dentistry, I do focus on big-case dentistry, so I'm not trying to point you in a different direction. I am trying to share a better path to it.
The mistake I see too many new dentists make is to overfocus on the complex, when the simple has yet to be mastered. That is very potentially brand and financial suicide. One failed case (either real or perceived by the patient), and the only thing that travels faster than the negative word on the street is the time and money it takes to redo the big case. Assuming, that is, the patient even allows it. More often than not, this is how I meet the majority of the patients I treat today.
The better path I see is to focus every small skill that adds up to the big case until each of those skills is on autopilot. That doesn't mean you're not going to push yourself. It just means you're going to steer clear of that one patient who sets you back.
If you want to win with it
If, after reading why not to focus on it, you're even more fueled to dive in, good for you! Here's a recipe to dive in successfully:
Think diagnosis excellence. The best dentists I've come to know from all over the globe can get to the source of the problem and see the future before it happens.
Think interdisciplinary care. Setting up big restorative cases with orthodontic movement and periodontal tissue tweaks is how the masters deliver incredible cases.
Think minimally invasive. No matter how skilled we are, dentistry begets dentistry. So, the more we can conserve tooth structure and/or bone, the better. Translation: if big cases mean restorative to you, work on banking tooth structure; if big cases mean implants to you, bank bone. Yes, there are true all-on-X cases out there. When done well, there are far more multi-implant cases that keep adjacent teeth around.
Think data. The Insta-fame isn't worth the long-term pain your patients will endure when we don't follow the science and the data that shows us what kind of dentistry actually lasts multidecades. Here's an example. Implants do not outperform well-done bridges. You might not like reading that, but truth is truth.
Think questions are the answers. As dentists, it's easy for us to get in dentist mode before we get in human mode. Today's patient is intelligent. They do their homework. They most often will guide us to the best solution if we ask rather than tell.
The team and tech you need
It turns out dentistry truly is a team sport, and we are much more capable when we work with our teams. Oh, and don't just think internal teams of assistants and hygiene. Think about your lab team too. We get exponentially smarter when we collaborate on the front end of every patient big case.
Now, add in today's top technology and it's a win, win, win. Here are some of what I'd argue are essentials:
- AI for diagnostics such as Pearl and Overjet
- Design software such as Exocad and Digital Smile Design
- If you're a chairside fan, mills
Wrapping up
There is a time and a significant place for big-case dentistry in 2025. If you're a new dentist and want to offer these services, there is also a best path to deliver it. Engage, educate, and empower your team. Take deep-dive CE, get mentors, and shadow to build your process. Be intentional as you focus on bread-and-butter dentistry to know how it fits into the bigger case picture (i.e., production).
When you want to learn more of who to look to—and the how—to for any of the above, click here. That'll lead you to my personal email. I will be happy to help!
