How to present dental treatment plans without the pressure or the pitch

This is a common scenario: you saw a new patient for their complete exam one week ago. Now they’re returning for their follow-up consultation to discuss your findings and treatment recommendations.  

In my last article, I discussed the importance of the complete exam as the cornerstone of a successful fee-for-service (FFS) practice. It takes time, knowledge, and confidence. It starts with the initial interview, continues through the comprehensive exam, including a complete photographic series, and ends with the treatment plan presentation. 

The best way to approach treatment plan presentations

For some dentists, the very idea of presenting a comprehensive plan of treatment to a patient can start their heart pounding and the nervous sweat to start. It can be especially daunting for a younger dentist to sit in a room, one-on-one, and suggest a range of services that could easily add up to thousands of dollars.  

What’s the best way to approach this? What is the most effective method to connect with the patient and get them to see the value of what you’re presenting?

The amount of ink (both digitally and real) that has been devoted to this subject over the years is astounding. A survey of methods and suggestions range from memorized scripts all the way to outright manipulation. I remember years ago I listened to a cassette tape in my car that detailed the exact way to get a patient to say "yes." It had to do with finding their "hot buttons,"—those issues they might feel passionately about—and directing your presentation to those issues. I immediately threw those tapes away and kept looking for a better way. 

As I journeyed through various CE courses and philosophies, I adopted the prevailing treatment plan presentation method at the time—sharing all their dental issues with the patient and then handing them a piece of paper with a well-thought-out list of recommended treatments with the fees.  

I would do a lot of talking, explaining, and trying to convince them of what they "needed," and I was met with a lot of blank stares. Boy, did I watch a lot of people leave my office after my very well-thought-out treatment suggestions. I felt frustrated by the lack of patient treatment acceptance and became increasingly nervous walking into the next presentation where I desperately wanted them to say yes. 

The next part of my presentation learning journey

It was about this time that I saw Frank Spear talk about his way of presenting treatment, and it made incredible sense. In a nutshell, Frank would present any and all treatment by saying, "This is what you have, this is what it means to have it, this is what we can do to treat it, this is what might happen if it’s left untreated, it is your mouth, what do you want to do?" It is simple, it is honest, and it takes the burden and pressure off me as the presenter and lets the patient make the decision. 

Here’s an example. A patient has a molar with a large old restoration that has fracture lines. It’s one thing to say, “You need a porcelain onlay on this tooth to prevent it from breaking and it will cost $2,000.” Maybe the patient will say “yes” if they trust you, or they may feel pressured and go to another office. 

It is much less adversarial to say (while showing them a clear crisp photo of the tooth on your monitor), “This tooth has an old and large filling with several fracture lines. The fracture lines are most likely from clenching forces over the years on the tooth, which is weakened by the large filling. If we leave it alone, it will probably break at some point. This could happen in five years, or it could be next week. I can take out the old filling and cover the tooth with a crown/onlay that will protect the tooth from breaking and minimize future damage. It’s your tooth. What would you like to do?”

Notice I did not mention the cost yet. As Frank Spear said, once you start discussing fees, it stops being a treatment planning discussion and becomes a financial one. I think of the treatment planning presentation as an educational experience for the patient. The goal is to identify the best treatment possible, and once agreed upon, we can then discuss fees and whether we want to do everything at once or create a five-year plan. Either way, the patient is an equal partner in the plan and thereby takes ownership.

Here’s another example. There’s a discussion about porcelain veneers. Sometimes this comes up in a hygiene appointment. Instead of rushing the conversation in the two minutes allotted to me, I ask the patient to come back for a complete exam, usually at no charge, and we have a relaxed talk using the photo series I took as the focus.  

When the inevitable question, “How many veneers do I need?” comes up, I don’t have to make up a number that I think they’ll agree to. Instead, we look at the full smile picture, see how many teeth show, and together we decide what makes sense. Now don’t get me wrong; I’ve already planned ahead of this appointment what I think will be best for the patient, and I will gently guide them toward that plan. Many times, the patient will ask, “What would you do?” Whatever they choose is their decision, and we’re equal partners throughout the treatment. 

I recently had a meeting with my accountant, and he said in an offhand way, “Yeah, my dentist tried to sell me some veneers, but I’m not interested.” That’s the difference between a sales pitch versus educating the patient. The latter is much more effective, and just as importantly, it’s so much more relaxing and enjoyable for both the patient and me. 

“Here’s what you have, here’s what it means to have it, this is what might happen if we do nothing, here’s what we can to do correct it, it’s your mouth, what do you want to do?” Memorize those words and you will be smiling instead of sweating when you walk into your next treatment plan presentation. Try it—it works!

Editor's note: This article appeared in the July/August 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.