Even though we may want to drive the sale of cosmetic dentistry to our patients, it is generally more profitable to allow the patient to take the wheel in this process.  The idea is to balance the notion of investigating what the patient really wants without “selling” the patient something she does not want. Fleshing out true desires is an art.  I have been disappointed at times when the desire for esthetic improvement was primarily my own and not the patient’s.  When this is the case, the patient tends to be even more critical of the work and more difficult to please.  Tread lightly with the patient who was actually “sold” cosmetic dentistry, I would caution.  Be sure to present all available cosmetic improvement options you can provide and then let the patient “buy” the treatment from you.