Here is my response with some enhancements…
Cosmetic is the icing of dental treatment - never will be much more - never has been much. See stats to back this up below.
About 50% of the population doesn't go to the dentist – while many don't because of price, they are also held back for reasons such as pain/fear/time and other worries.
Cosmetic dentistry is down at the bottom of the list – under deeply ingrained and established dental value system. If we don't think about 'fear or pain’ when we think about dentistry, we think about “basic dental concepts’ like preventive health, cleanings, fluoride, etc." – because it is often connected tightly to insurance – which means they probably go every six months and mostly because it is paid for.
And therefore, these people have little need for more than one or two teeth of restorative work, which makes them less likely to value cosmetic dentistry in any big way. The closer a consumer is to needing a smile makeover – the more likely they will “value” the cosmetic element of dental care.
Other reasons people "think basic dentistry"... fixing a broken tooth, toothaches and then dentures. This leaves very few people who think about jumping the fence of those ideas/issues to get to "beauty". So, if 50% of dentists are pushing "cosmetic" in some way (in your area) and a few are really promoting it publicly - the pickings get very small. While the economy hammered it even more – pure cosmetic dentistry marketing had little potential to be successful - whether you are "doing it right" or not.
What happens is the pipeline is narrowed too small when cosmetic dentistry is seen as the “focus” of a dental practice. While a narrow focus is good to help a specific service standout, the reality barrier needs to be given its due.
Once a dentist goes a very specific cosmetic dentistry route, they could have trouble avoiding the problem of: If you are a hammer (cosmetic focused) everything is a nail (everyone really should want a cosmetic makeover). The dentist can start seeing it “everywhere” and believing more people should want it. These dentists could get in over their head - recommending treatment without considering all the implications, doing it too fast, before the dentist really knows what is possible or even getting beyond of their experience.
What needed to happen with cosmetic dentistry was for a designation like "pediatric dentists" to develop where a "specialist certificate" could be attained. Now all parents want to take their kids to Pediatric dentists. Instead, every dentist could become a cosmetic dentist. Of course, children's dentistry has an ACE in its hand from a acceptance perspective - because parents will do a lot for their children.
Anyway, cosmetic dentistry has many benefits in promoting dentistry and for the dentist and the patient. Dentists love the effect and artistry - the consumer on a limited basis has another more positive entry point for going to the dentist. Good "cosmetic dentists" can get patients from either those dentists who don't do it or those who really aren't that good at it. But this strategy is very limited and promoting cosmetic dentistry too much changes the dynamic the other way - you get less of the other basic dental patients (which there are many – not going to the dentist as of now) and even confuse current patients.
Most people are like us. They don't do "cosmetic things" to any large extent; makeup, hairstyles and tanning are a long way from going to a doctor for a cosmetic change. As we have discussed before, if cosmetic changes were ingrained in people like us - the first thing I would need to do is get a nose trim.
So what can be done? Open up the pipeline - by talking about the overall value of advanced dentistry - make sure consumers know you do things right - get health right and then move to esthetic issues. Most dentists still do middle of the road - a few swing to the other side of the spectrum, and a few try the cosmetic boutique practice.
We need to tell people things are different overall – show them some boutique concepts - but avoid the hype, and talk a lot about comfort, health, value, lifelike, etc.
Let them know you have the "icing" services and expertise - get a few more of the "all esthetic" group of consumers - get a few more "never thought I would do something like this smile makeover type patients" – which will greatly improve the numbers of patients that want dentistry - but only if it is done well and is mostly about health.
No one thing will work – marketing or services - and some might be dead ends - but getting too far ahead of the consumer - even though your expertise is - should be avoided. You will get your cosmetic cases and your smile makeovers - more and more of them - because we will move them in that direction - but mostly you will work with people like me - who won't ever trim their BEAK - but will come to you because you are an "expert" in understanding them as well as keeping them healthy.
Think of your cheap relative (we all have them) that pays all your fees - but never really does what they should and keeps coming to you because they trust you - even though you keep reminding them that they are not flossing regularly and will probably need dentures soon and finally come around after 3 or 4 teeth fall out.
The marketing we do will be nice - but will also "coax" consumers to do the right thing, finally.
And REMEMBER - if we consistently communicate the value you, your office and advanced dentistry offer (which includes a beautiful natural looking and feeling smile) the numbers will add up.
There is NO magic marketing formula (no matter what the videos on youtube.com promote) except that there are people out there that don't know about how you do things. The overly hyped cosmetic dentists crowded out dentists like you to some extent, but they also went in a direction that had only a small base to draw from. Plus these dentists also confused the consumer about dentistry – making it something that it will only be on the margins: a cosmetic service.
But if these people knew about your approach to dentistry, many of them would come to you - it just might take time to find them - or get them to understand that it is really true, which means vigorously building trust and effectively showcasing and explaining value.
DENTAL VISITS STAY FLAT STATS
Cosmetic dentistry and all the other advancements in dentistry don’t seem to have done much to move people beyond the basic dentistry model most of us are aligned with.
Here is a stat that backs this up. "Overall, there was no change in the percentage of the population with a dental visit from 1996 to 2004." SeniorJournal.com