Content Dam De En Articles Print Volume 108 Issue 3 In Every Issue Editor S Note The Embarrassing Thing About Case Acceptance Leftcolumn Article Thumbnailimage File

The embarrassing thing about case acceptance

March 20, 2018
Dental Economics’ Chief Editor Dr. Chris Salierno says the funny thing about case acceptance is that dentists think they’re doing better than they actually are. Do you know how to calculate case acceptance? When is the last time you did?
Chris Salierno, DDS, Chief Dental Officer, Tend

The funny thing about case acceptance is that dentists think they’re doing much better than they actually are. I’m guilty of that too. When is the last time you calculated your case acceptance? How would you even arrive at a number?

First, let’s agree on a formula. Take the amount of dentistry that has been accepted in a given time period and divide by the amount of dentistry that was treatment planned in that same time period. Seems simple, right? Well, how do you know if treatment has been accepted? I’ve had plenty of patients say “yes” to my face, only to realize they never received their care when we meet at their next hygiene appointment. If we instead use the amount of dentistry performed in a given time period in the numerator, then we fail to account for situations such as complex, multivisit dentistry.

In my opinion, the success of a key performance indicator (KPI) relies less on the exact formulation and more on just actually measuring it regularly. So, however you choose to measure case acceptance, just be consistent.

OK, now that we’re measuring case acceptance, what should be our goal? If you search through the annals of Dental Economics online, you’ll see 90% as a common target. If we’re falling short of the goal, then there is an element of the patient experience that is missing. So why don’t patients accept treatment?

I have yet to see research that asks patients why they visited a dentist but decided to delay treatment. In 2014, the ADA conducted a large survey of the public, screening for those who did not plan on visiting the dentist in the next 12 months.1 The three most common answers given were cost, the perception that their mouth is healthy, and not having time to make an appointment. If we were to ask our patients why they did not agree to our treatment plans, I think we’d hear something very similar.

In this issue, several authors have offered their insights as to how to overcome common obstacles to treatment. Case acceptance is a system like any other in our practices. If we’re not hitting the target KPI, then we must reexamine everything from marketing to the hygiene experience to the financial consultation and see where we’re losing engagement with our patients. We shouldn’t be embarrassed if we’re only at 70% case acceptance; we should be embarrassed if we don’t measure at all.


Chris Salierno, DDS

[email protected]


1. Yarbrough C, Nasseh K, Vujicic M. Why adults forgo dental care: Evidence from a new national survey. Health Policy Institute Research Brief. American Dental Association. Available from: Published November 2014. Accessed February 2, 2018.

About the Author

Chris Salierno, DDS | Chief Dental Officer, Tend

Chris Salierno, DDS, is a general dentist from Long Island, New York. He graduated from Stony Brook School of Dental Medicine in 2005. Dr. Salierno lectures internationally on clinical dentistry, practice management, and leadership development. In 2017 he became a chief development officer with the Cellerant Consulting Group, and he was the chief editor of Dental Economics from 2014 to 2021. In 2021, he became the chief dental officer at Tend. He can be reached on Instagram @the_curious_dentist.

Updated May 13, 2022

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.