Content Dam Diq Online Articles 2015 07 Dentist Patient Collaborate 1

Communicating trust – the key to dental case acceptance

July 9, 2015
In today's competitive dental environment, no longer do dentists tell patients what to do. Educated patients respond to dentists who listen to them, and who they can trust. What can you do to get patients to say 'yes' to treatment?

Patients’ perceptions, and oral health in general, have changed radically in just a few generations. The success of a modern dental practice depends entirely on how effectively it can influence patients to say “yes” to optimal dental health.

It’s simple consumer economics – no matter how exceptional the practice, if patients reject the recommended treatment and won’t (or can’t) pay more than it costs to provide it, that particular practice may no longer exist. Professional finesse may not necessarily win the day either. Roughly 85% of case acceptance stems from a dentist’s ability to relate to his or her patients, while just 15% is due to technical proficiency.

Case presentation has evolved significantly in recent decades, thanks to demographic changes, broader access to dental information, and patients’ realizing that proper dentistry is a core component of their overall health. The traditional case presentation method was simple – the problem-solution disease model. Something’s broken? Fix it. There’s a disease? Remove it. “Only repair that which is broken”? The mantra. This mindset included emergency dental care and tooth removal because patients in this bygone era regarded tooth loss as unavoidable.

ALSO BY LISA PHILP: Hiring strategies for your dental practice

Communication consisted primarily of the dentist telling the patient, “You have a problem, and I have the solution.”Patients in this traditionalist time took their dentist’s opinion as fact and seldom questioned it. The most common patient objection, quite reasonably, was fear of the dentistry being extremely painful.

Then along came the era of “prevention rather than repair,” which was the result of more widespread dental insurance coverage and, not coincidentally, the rise of the cosmetic revolution. This occurred when baby boomers began to age yet still valued their appearance. They accepted regular hygiene checkups as common practice and even underwent smile enhancements that were not medically necessary.

Communication grew to include education, education, and more education. Bombard patients with information. You mean losing teeth is no longer a certainty? You don’t say!

Dentists’ new techniques — reception-room education, before-and-after photos, chairside videos, brochures, and the intraoral camera — became highly effective, and took advantage of the fact that many people learn visually. Dentists persuaded their patients to be proactive about their oral health, and armed with substantially more information than previous generations, patients made much smarter decisions.

The challenges were that patients might become overwhelmed by the complexity and number of treatment options, and flummoxed by dental terms and descriptions.

The challenges were that patients might become overwhelmed by the complexity and number of treatment options, and flummoxed by dental terms and descriptions. In the clinical area, patients often signaled “agreement” with their dentist by smiling and nodding. Dentists falsely registered patient acceptance and stop talking. Once patients got to the checkout desk, however, their main objection was the limitations of their insurance policy, which in turn created a massive increase in pre-determination submissions.

Case presentation today has entered the era of “comfortable influence.” This entails the entire dental team offering evidence of the systemic link between oral health and overall health. No one wants to get sick, look old, or die early, and a message of “oral health is the gateway to full-body wellness” is sure to meet with a positive reception. This mantra, coupled with the “seek first to understand, and then to be understood” approach, supports patients making informed decisions.

Patients will say yes more often if they think their dentist is interested in their well-being, and is a trusted partner and not a condescending teacher or salesperson. A trusted advisor does not tell patients what they “need,” what they “ought to do,” or what they “have to do.” Dentists should ask questions first, then devise a treatment plan that addresses each patient’s situation.

“Learned communication skills,” in words, tone of voice, and body language, best describes today’s communication techniques. These include building a rapport within minutes, becoming an expert interviewer, learning to listen without judgment, and showing that you understand how patients see a situation before telling them how you see it.

When you take the time to learn about patients’ long-term health-care plans, they’re much more likely to trust your intentions. Trust breeds case acceptance, and you become an active part of patients’ decisions. Your power to influence is strong, but optimally it will help patients make their own decisions with as little coercion as possible.

Research and anecdotal evidence show that patients who feel their dentist’s authentic desire to collaborate rather than dictate are much more likely to develop a better relationship with their dentist. They are also more likely to consider dentistry as a significant part of their overall health plan. What stands in the way of case acceptance for practices today is not cost objections, but dentistry’s lack of perceived value. Overcome that, and your case acceptance will climb.

Lisa Philp, RDH, is the president of Transitions Group North America. As one of dentistry’s most sought after leaders, coaches, authors, and speakers, her mission is to allow dental professionals to achieve fulfillment in the workplace. Visit her at