One of the most challenging aspects of dentistry is working with people, as they have a wide variety of personalities and expectations. Most patients respect the dentist and the team and appreciate the treatment they receive—but every practice has a segment of patients who can be difficult. The question is: how can you successfully manage these situations? 

Acknowledge that difficult patients exist 

The first step in dealing with difficult patients is simply recognizing that they exist. Dentists and team members start each day with the goal of providing excellent care, maintaining a positive attitude, and guiding patients smoothly through both clinical and administrative aspects of their visit. Very few team members walk into the office each day wondering which patients will be difficult, unfair, or disrespectful. 

That said, it’s important to accept that every practice will encounter difficult patients; it’s part of working with people. Being aware of this reality allows dentists and team members to identify challenging situations early and respond appropriately. 

For example, a patient who becomes unusually quiet or displays negative body language may not voice concerns in the treatment room but may express dissatisfaction at the front desk, where they feel more comfortable. The key is to recognize as soon as possible that something may be wrong and address it proactively. 

Develop a plan 

A common mistake is when a front desk staff member expresses uncertainty over how to respond to a complaint. Handling an unhappy patient is not the time for uncertainty, which is why having a clear plan ahead of time makes it much easier to navigate potentially awkward situations. Here are some steps staff members can take: 

• Apologize. The front desk team member should acknowledge the concern immediately: “Mrs. Jones, I’m sorry to hear that.” Whether the patient is right or wrong is not the issue. An apology helps diffuse tension, makes the patient feel heard, and opens the door for productive communication. 

• Notify the doctor. Next, thank the patient for the feedback and let them know it will be shared with the doctor. The dentist should be informed at an appropriate time—typically at the end of the day—so they can address the issue without disrupting patient care. 

• Contact the patient and follow up. Whenever possible, the doctor should personally contact the patient that evening. Many dentists avoid these conversations because they are uncomfortable or emotionally charged. However, a calm, professional call can make a significant difference. 

Consider the following scripted call: 

“Mrs. Jones, this is Dr. Smith. Julie, our front desk coordinator, mentioned that you were less than satisfied with a certain aspect of your visit today. I wanted to reach out to better understand what happened so we can improve and ensure it doesn’t occur again.” 

At this point, the dentist should listen carefully and avoid becoming defensive. Acknowledge the concern, express appreciation for the feedback, and communicate a commitment to improvement. 

This approach has prevented many patients from leaving a practice, posting negative reviews, requesting refunds, or sharing negative experiences in the community. While no solution is perfect, this one is highly effective because people value being heard and respected. 

Should you ever give a patient their money back? 

There is no simple answer to this. Refunds should be handled thoughtfully, with a focus on resolution rather than emotion. Too often, decisions are driven by a sense of right or wrong, leading to rigid positions that escalate conflict. Consider the following factors: 

• How much money is involved? Focus on the amount being requested, not whether the patient “deserves” it. If a relatively small refund can resolve the situation, it may be advantageous to provide it. Set aside emotion and ask: is this amount worth resolving the issue and preserving peace of mind? 

• Is the patient being unreasonable? There are situations where a refund is not appropriate—particularly when the patient’s expectations are unrealistic and quality care is provided. In these cases, a direct and respectful conversation is best. Acknowledge their perspective, explain the clinical outcome, and offer to continue care if appropriate.  

Realistically, patients who are denied a refund often choose not to return—but that may be the best overall result in certain cases. 

• Is the patient simply unhappy? 
Some patients are dissatisfied but not confrontational. Proactively asking about their experience can uncover concerns early. In some cases, waiving a fee can preserve the relationship and build long-term goodwill. 

Again, this is not about being right—it’s about reaching a positive resolution. 

Communication and customer service 

Many difficult situations stem from miscommunication or lack of communication. One of the most common mistakes is assuming the patient fully understands what has been explained. Always conclude explanations by asking if the patient has any questions. This step is often skipped due to time pressure, but it is essential. 

Customer service also plays a critical role. Even when clinical care is excellent, poor service can leave patients with a negative impression. For example, a patient may perceive the entire visit negatively if a team member appears distracted or inattentive to them —even if the clinical outcome is excellent. 

Perception matters. Poor customer service can undermine the perceived quality of both the appointment and the treatment itself. 

Strong communication helps prevent these issues. Check in with patients frequently during treatment, ask how they’re doing, and let them know how things are progressing. These small actions build trust and significantly improve the patient’s overall experience. 

Summary 

Some patients have consistently difficult personalities and create challenges wherever they go. Fortunately, they represent a small minority—and may not be the right fit for your practice. 

Most difficult situations, however, involve reasonable patients who are unhappy for specific reasons.  

These cases can usually be managed effectively through awareness, communication, and a structured approach. By applying these strategies, you can turn challenging interactions into opportunities to strengthen patient relationships and improve your practice. 

Editor's note: This article appeared in the June 2026 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.