What a 92 Percent Case Acceptance Rate Looks Like in Cosmetic Dentistry
Welcome back to another episode of the Digital Dentistry Decoded podcast. Dr. Ahmad here from iDD.
This week I sat down with Dr. Brian Harris, a cosmetic dentist in Phoenix, Arizona, with over 330,000 followers on Instagram built around his smile transformation cases.
We moved away from the CEOs and CFOs of the dental tech world for this one. Brian is a clinician first, and honestly, that made this one of my favorite conversations in a while.
Listen to the episode below or continue reading to find out more.
Episode at a Glance
- Dr. Brian Harris screens every cosmetic patient through a free virtual video consult before they ever see him in person, using a platform called Smile Virtual.
- That process gets him a 92 percent case acceptance rate on treatment plans over $15,000, because patients already know his fees and recommendations before they walk in.
- He still designs every mock-up freehand with flowable composite rather than digital design software, and does this "smile test drive" for around 80 percent of his cosmetic patients.
- 3D-printed veneers, through Neer and through SprintRay's Crown HT material, have become good enough that he now offers them as a genuine mid-tier option between reshaping natural teeth and full porcelain veneers.
- He organizes his cosmetic offerings into three named tiers rather than pitching procedures one at a time, an approach he compares to how Porsche sells the Boxster, the 911, and the GT3 RS.
- His closing philosophy, drawn from a TEDx talk he gave, is "connection before conversion."
Who Is Dr. Brian Harris
Brian grew up around dentistry, and in a way, so did I.
We talked about this off camera. My dad's a dentist too, and I was inspired by him the same way Brian was inspired by his.
His father went through what Brian calls a radical transformation in the early nineties. He'd attended one of the first live-patient cosmetic courses at the Baylor Aesthetic Continuum, alongside names like Bill Dickerson and David Hornbrook.
"I saw him go through this radical transformation personally," Brian told me. That course changed his father's career, helped found what became LVI, and pulled Brian, and eventually both of his brothers, into dentistry.
Twenty-two years into his own practice, Brian now does only smile cases. About 85 to 90 percent porcelain veneers. The rest, 3D-printed hybrid restorations.
On materials, he's old school and happy to admit it. E.max first, zirconia if not. He's an Ivoclar guy across the board, ZirCAD Prime included.
For scanning, iTero is his workhorse, with CEREC and a newer scanner called Ori in rotation too. I'll admit I'm a fan of the Lumina myself, so it was good to hear it's serving him well.
The Virtual Consult That Does the Selling Before You Meet the Patient
Here's where it gets interesting. Every lead Brian gets, whether from Instagram, his website, or word of mouth, goes through a recorded video consult first, using his own platform, Smile Virtual.
"Upload a smile photo, tell me what you want to change, and I'll send you back a video with my recommendations, options, and a full cost breakdown." That's how Brian described it to me.
By the time a patient walks into his practice, they already know his fees. They know his work. They know what he's going to recommend.
The result, Brian says, is a 92 percent case acceptance rate on everything over $15,000. That number stopped me for a second when he said it.
He records two or three of these five-minute videos every morning at the clinic and estimates 45 to 50 virtual consults a month.
For patients who do book an in-person consult afterward, Brian charges $99, not as a revenue line, but as a filter for who's actually serious.
If you're just starting out and your book is quiet, his advice is simpler. Do it for free. The repetitions matter more than the fee at that stage.
From a $400 Wax-Up to a Freehand Smile Test Drive
Brian doesn't use exocad. He doesn't use any digital design software at all. Every mock-up is freehand, chairside, flowable composite, a bur, and some discs.
That wasn't always the plan. Wax-ups used to cost him $40 a tooth and take two and a half weeks to come back.
"It's $400. Who's paying that?" is basically where his head was at. So he taught himself to do it freehand instead.
He calls the result a "smile test drive," and he does it for around 80 percent of his cosmetic patients. He skips it when someone's clearly in a hurry, or when the natural teeth are already too flared or crooked for a clean preview.
What struck me was how he manages the reveal. He never frames it as a big moment. "I don't ever want my patients to feel like they have to be forced to liking something," he told me.
He shows them the mock-up, then walks through everything he'd still change, so the eventual temporaries land closer to ideal.
Where 3D-Printed Veneers Actually Fit Now
Let's address this directly. Brian was burned by 3D-printed restorative materials a couple of years ago. In his words, they looked terrible. Opaque. Not something he could ever pull off as a final restoration.
What changed his mind was SprintRay's Crown HT material. Brian estimates it at around 65 percent ceramic content, with a real jump in translucency over what he'd tried before.
He's got around 25 printed smile cases in the mouth now, the longest running about 14 months.
Alongside his own printed work, Brian also sends patients to Neer, a company that prints veneer overlays patients can wear at home before committing, sometimes even as the final restoration. A hundred dollars a unit, no printer or design skill required on his end.
Together, these two paths are what let Brian offer a real middle tier now. Not just porcelain or nothing.
He's upfront about the trade-off, too. Half the cost of porcelain, and he tells patients to expect roughly half the lifespan. Call it seven years against fifteen to twenty for porcelain.
I appreciate that kind of honesty going in, rather than patients finding out the hard way later.
Naming Your Menu, the Porsche Way
This was my favorite part of the conversation, and I think every cosmetic dentist listening should steal it.
Brian doesn't pitch procedures one at a time. He presents three named tiers. Smile Shape (enamelplasty, gingivectomy, and whitening on natural teeth), Smile Sculpt (the 3D-printed option), and full porcelain Smile Design.
"Three is the magic number," he told me. "You start going four or five, it's too complicated."
His comparison was Porsche. You can buy a Boxster, a 911, or a GT3 RS, and all three are still Porsches. Nobody needs convincing between them. They just pick the one that fits.
How many of us actually have something this clear laid out for patients? Probably not many, myself included.
Being Honest About Longevity and Complications
I asked Brian what patients want to know most before committing. Longevity, every time.
His answer doesn't dodge anything. He's had his own veneers for 22 years without an issue, but he tells patients straight that most cases run 15 to 20 years, not a lifetime guarantee.
If something happens in the first five years, he covers it, as long as patients stay current with their cleanings.
On complications, same approach. A reshaped smile can change a patient's bite. He says so upfront rather than waiting for it to come up after the fact.
What's Next
Brian closed with something he's also delivered as a TEDx talk. Drop the sales process, focus on what the patient actually wants, and trust follows.
Connection before conversion, as he put it.
If you're building out a cosmetic offering of your own, whether that's a 3D-printed tier, a virtual consult process, or just naming your existing services properly, this is a conversation worth listening to in full.
If you have any questions, please leave them below.
