Content Dam De En Articles Print Volume 107 Issue 12 Practice Tips To Increase Case Acceptance Leftcolumn Article Thumbnailimage File

Tips to increase case acceptance

Dec. 5, 2017
In this article, Dr. Patel gives 11 tips for increasing case acceptance. He also discusses why dental practices should build in time each day for same-day dentistry.

Shalin Patel, DDS

What separates high-earning doctors from the low-earning ones? There are many things, but one of the most important is case acceptance. You may be the best clinician with the most precise hand skills, but if you cannot articulate why patients should allow you to treat their dental needs, then your success in dentistry will be limited.

There are several ways to promote higher case acceptance, but they require following consistent principles to ensure the patient is educated effectively and given the option to start treatment in a timely manner. Here are tips to increase your practice’s case acceptance.

Establish rapport—Most dentists are so busy going from operatory to operatory that they do not take a minute to consider the patient’s perspective. Do not just walk in, introduce yourself, and lean the patient back to get to work. The patient is already nervous and may take time to warm up. You want to leave a lasting impression, and a big part of that is having the ability to converse about topics that are far from dental related. If you are having a hard time getting started, let the patient start the conversation by asking about easy topics, talking about the weather, recalling the big game last night, or describing weekend plans.

Ask key introductory questions—After establishing a comfortable atmosphere, there are three main questions you should ask:

1. What brings you in today?

2. When was the last time you saw a dentist?

3. Were there any problems during your last dental visit?

This last question is important not only for the answer; it also helps with something you should always learn when meeting a new patient. What did the other dentist do or not do that has gotten this patient in my chair today?

Establish that time is not an obstacle—When considering future treatment, many patients will ask, “How long will it take?” I always teach my associates not to answer this question, as it is too hard to predict. The most common reply I hear is, “It will take about an hour to an hour and a half.” This is giving your patient a reason to say no or to reschedule (and we know how a rescheduled appointment can easily lead to a cancellation or a no-show). Instead, the best way to respond to this question is by answering with a question. If a patient asks me how long it will take, my immediate reply is, “What time do you need to be out of our office today?” This will give you a much clearer idea if same-day treatment is an option.

Focus on same-day treatment—In my practice, this is a key indicator to our overall efficiency. The world is changing, and people prefer things done immediately, yet still effectively. People are constantly being given options to have things done in a more efficient manner, and you must adapt your practice to follow this same trend. Your office and team should allow time and strive to offer same-day treatment for the majority of cases. This all starts with practicing saying the word “today.” Our team makes sure we use this word multiple times throughout each appointment to make the message clear that our office can offer a service that sets us apart from many others. Here are some examples:

  • The assistant: “The doctor will look over your teeth and can address any concerns today.”


  • The doctor: “I really want to focus on this today because I do not want it to get any worse.”


  • The front office: “Here is the treatment plan that the doctor recommends and has time to complete today.”


Stress urgency—It is easier to get a patient to stay for treatment when they are in pain because the patient is already feeling the consequence of not having treatment. By that same principle, when a patient comes in without pain, you must remember to emphasize the same type of urgency. As dentists, we tend to focus on what needs to be done, but it is more important to focus on the consequences if the procedure is not done.

Use pictures, not words—Most of your case presentation should be showing intraoral pictures instead of showing bitewings or periapicals. Also, make sure you show these pictures on a big-screen TV to ensure the patient fully understands the problem. You can also use intraoral pictures to show previous cases that are similar, especially those that demonstrate the consequences of leaving the problem untreated. Another important tip is to make a point to leave the picture of the problem area on the screen as you transition from case presentation to financial presentation. These few minutes alone allow the patient to look at the screen in silence to think about the issue and come to the realization that the problem needs to be addressed.

Remove the fear—Always use reassuring terms throughout your case presentation, such as simple, basic, quick, and easy. When you are doing something that is more complex, make sure to emphasize how often you perform this procedure so the patient is at ease that it is routine. This exhibits confidence and makes the patient much less apprehensive. A combination of both confidence in your experience and reassurance in every procedure is a sure way to get more case acceptance.

Use everyday language—Another way to ease patients’ fears is to give them step-by-step, easy-to-understand explanations of what is needed. Do not make it confusing. Speak to patients at their level instead of in technical dental terms. You do not need to use terms like caries, calculus, radiograph, or interproximal, as these terms are just different ways of saying cavity, tartar, x-ray, and between.

Although we are taught to speak in a certain way during dental school, it is important to remember that patients do not understand these terms, which can make the process seem more complex to them than it really is. For example, if someone needs a scaling and root planing, do not talk about the need for the scaling due to “pocket depths and subgingival calculus.” Use layman’s terms, then give an example: You can tell them that doing dental work without a deep cleaning is like trying to fix a house (doing the dental work) with a bad foundation (inflamed gingiva/bone loss).

Offer free whitening at the right time—We offer free whitening trays and refills on gel at recall visits to all new patients who come into our practices. This encourages new patients to both come in initially and return. We also utilize this for case acceptance by always putting the whitening at the bottom of every treatment plan. When the front office reviews the financials, they reinforce that once the treatment is complete, then the patient will get new trays. If you take impressions as soon as the patient sits in the chair, it devalues the recommended treatment and the trays. You want to explain the importance of stabilizing the patient’s dental health before doing whitening.

Always offer financing—A third-party financer such as CareCredit is a great tool for overcoming a patient’s financial concerns. Patient financing should be easy to use and allow instant approval.

Avoid money talk—I believe in the rule that the front office should handle the finances, whereas the clinical team should handle the dentistry. You never want a patient to think of payment for a crown as if it were an unavoidable car payment. Furthermore, if there is a billing question or dispute, you as the dentist should always keep yourself out of the equation. However, if you know a patient does not have insurance, it is OK to mention things the practice offers, such as flexible payment options, financing, and the fact that your office will help as much as possible to help fix the issues. This shows genuine compassion and understanding, and it makes the patient feel valued.

Editor’s note: Article supported by CareCredit.

Shalin Patel, DDS, is a part owner and the chief clinical officer at DECA Dental Group, which has been named as one of Inc. 5000’s fastest growing companies in America. He oversees new doctor recruiting and has created unique and innovative systems to train hundreds of dentists in office locations across Texas. He can be reached at [email protected].

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