Better Cosmetic Restorative Results, Same Appointment Time, with Dr. Susan McMahon
- Dr. Reza Ardalan
- Jul 15
- 5 min read
By Dr. Reza Ardalan
Ask a room of general dentists which procedure they least enjoy, and a lot of hands go up for the anterior class four. It looks flat when you finish. You catch the fracture line the second the patient stands up. Dr. Susan McMahon, an AACD-accredited cosmetic dentist in Pittsburgh, thinks that dread is a training problem, not a talent problem.
When she joined me on The Dental Slang Podcast, the line that stayed with me was a simple one: the kind of anterior work we all admire on social media is not a secret gift. It is a system, and a system can be taught. Here is what she means, and why it should change how the rest of us think about cosmetic dentistry.
Great Restorative Dentistry is a Skill Set, Not a Gift
Dr. McMahon's central claim is that high-end esthetics is not a special talent a few people are born with. It is a repeatable skill set, and one you can learn and then hand to someone else. In her words, you can build a beautiful restoration predictably and simply, without turning a single class four into a two- or three-hour ordeal. She teaches general dentists restorative skills that go well past a posterior class two, and she is blunt that most dentists are closer than they think. The barrier is not ability. It is having a set of steps to follow.
You Probably Already Have the Chair Time
The objection Dr. McMahon hears most is time. No insurance-based practice can add two hours to a restorative appointment, and she agrees. Her answer is that a systematic approach does not add time; it removes the guesswork that was costing you time in the first place. If you can do a class three in 30 minutes now, she says, you can do a beautiful class three in that same 30 minutes, one that does not turn gray, does not leave a black triangle, and does not lose its sheen a month later.
The class four is the same story. Knowing the exact sequence is what takes a restoration from flat with a fracture line to something the patient stands up and thanks you for. Diastema closure and black-triangle correction are where she sees the biggest wins on younger patients, and by her estimate black triangles turn up in as many as 40% of clear-aligner cases. She is careful to frame this as finesse rather than reinvention. You are not changing every material or rebuilding your practice. You are changing how you layer, and doing it the same way every time.
The Materials Finally Caught Up
Part of why this is teachable now is that the materials do more of the work than they used to. Dr. McMahon points to single-shade composites that polish beautifully and hold up, no-prep veneers for cases the orthodontist has set up well, and a menu of enamel surface treatments, from microabrasion to resin infiltration to whitening used in combination. Add chairside 3D printing, and the learning curve that used to run 20 years has gotten a lot shorter.
This is where my pediatric side leans in. I see the same teenagers she does, coming out of orthodontics unhappy with a lateral incisor or a bit of spacing, and the conservative, minimally invasive options now on the table are exactly what that age group needs. Bonding, enamel treatments, and no-prep work let us address a young patient's concern without committing to anything aggressive. Dr. McMahon has built a real referral base on precisely that idea.
The Patient Experience is a System Too
The part that reframed things for me is that Dr. McMahon does not stop at systematizing the composite. The conversation is a system as well. Every patient enters her Pittsburgh practice through what she calls a smile consult, and it starts with photography. She never asks a patient what they dislike about their teeth, which only puts people on the spot. She takes photos and reviews them together with the patient, and that opens the door on its own.
None of it requires a fancy setup. Her consults happen in a regular operatory, not a dedicated closing room, with a piece of black felt on the wall as the studio. A face scanner and an intraoral scan gather the clinical picture, but the knee-to-knee conversation in the first few minutes is the part she values most. The system is what makes the result predictable, in the composite and in the chair.
The Takeaway
What I took from Dr. McMahon is that the thing standing between a lot of us and the work we would love to be doing is not talent and it is not time. It is a set of steps nobody handed us. She is trying to fix that, including through an online course she developed around five restorative systems, each one a different type of restoration taught in about an hour. If you have ever avoided a class four because you were not sure it would look right, that is worth sitting with.
Listen to the Full Episode
Dr. McMahon and I get into all of this on the episode, including how she rebuilt her practice around the work she actually wanted to do. Hear Dr. McMahon walk through her class four and diastema-closure systems in her own words. Listen to the full episode here.
About Dr. Susan McMahon
Dr. Susan McMahon is a clinician and educator whose teaching focuses on conservative techniques that preserve natural tooth structure. She lectures internationally on minimally invasive cosmetic and restorative work, sharing the techniques she uses in her own practice with general dentists worldwide.
As an Accredited Member of the American Academy of Cosmetic Dentistry, Fellow of the American Society for Dental Aesthetics, and Fellow of the Academy of General Dentistry, Dr. McMahon leads one of Western Pennsylvania’s premier cosmetic dental practices. She has been named a Top Dentist more than 20 times, including consecutive annual selections as a Top Pittsburgh Dentist by her peers for more than two decades. You can follow her on Instagram at @smilesandthecity and @dr.susanmcmahon.
About the author
Dr. Reza Ardalan is a pediatric dentist in Florida and the host of The Dental Slang Podcast, where he talks with clinicians about the craft, the business, and the human side of dentistry. Follow the show at @dentalslangpodcast and Dr. Ardalan at @DrRezaArdalan.
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