The Road to Increasing Case Acceptance

What’s the rate of case acceptance at your practice? Most dentists won’t know the answer to that question. But understanding case acceptance and what it takes to move a patient from presentation to accepted treatment plan can have a major financial impact on your practice.

Patel believes building a relationship of trust is a key factor leading to increased case acceptance.

When it comes to measuring case acceptance, or being consciously aware of it, for that matter, many dental practices come up short.

More often than not, the focus of a dental practice, says Shalin Patel, DDS, chief clinical officer and co-owner of DECA Dental Group, is on the clinical side of the equation. Which, he agrees, should always be the primary focus.

But there’s a caveat.

“The only way they’re going to be able to get more clinical procedures is by studying their case acceptance,” Patel says. “It’s about what can they do to provide more dentistry to more people, and get more efficient at what they’re doing.”


Patel says that, in his conversations with dental school graduates, the two most requested points of assistance are mentorship, and help with non-clinical aspects of dentistry — two areas they feel they received little or no exposure to while in school. They want to better understand insurance — the business component of dentistry. And they want to know more about case acceptance.

But, Patel adds, that’s not the fault of dental schools.

“There are so many different ways to practice,” he says, explaining there are private and group practices, specialties, or practices operating in a public health setting. “It’s something that dentists aren’t getting enough exposure to, and they need it once they get into the real world of practicing dentistry outside of an educational setting.”

And one of the first lessons is that increasing case acceptance should not be dependent solely on the dentist. That means everyone at the practice plays a role. For example, the minute the phone rings, staff needs to take steps to convert that call into an appointment. And when scheduling appointments, make certain the schedule is set up for success.

“If the patient elects to do same day treatment, there should be time available to make that happen,” Patel says. “And of course, making sure everyone understands the importance of the patient returning again and keeping a recall status where they want to continue to come back and develop more of a relationship.”


Patel believes building a relationship of trust is a key factor leading to increased case acceptance. To that end, communication is key. That means avoiding jumping right into clinical talk. See the person in your chair as not only a patient but as a human.

For example, ask them about their weekend. Create a little bit of a conversation, because patients tend to already nervous. They’re anxious because they’re meeting a new person, or because they usually associate fear with dentists. It’s important to break down those barriers initially in the conversation and get their mind away from what’s about to happen. And then, slowly integrate the clinical talk.

“Always ask open-ended questions,” Patel says. “For example, ‘What brings you in today?’ Relationships develop by creating rapport, which also develops trust. Patients feel they can connect with you not just on a clinical level, but also on a personal level.”

When it comes to clinical talk and educating patients, avoid talking in dental terminology. It’s an easy hole to fall back into while doing case presentation because it’s the norm while a dental student. It’s the way their colleagues or professors talked. Patel suggests dentists flashback to when they first entered dental school and tried to understand what radiolucency was, or what the pulp chamber looked like.

“We’ve done this for so long we don’t put ourselves in the patient’s shoes,” he says. “If there’s periodontal disease, showing white specks on an x-ray isn’t going to get the message across. But showing red inflamed gingiva, showing calculus, that will be a lot more understanding for a patient to be able to accept.”


Patel says that dentists can begin the journey toward increasing case acceptance by looking back over a three- to four-month period. How many consultations were done? And out of those, how many treatment plans were actually started? Establish a baseline, and look to build from there.

“If a treatment plan is being presented, and there are a lot of cases not being accepted, there may be an opportunity just from a presentation and communication perspective to improve that number,” Patel says.

What’s a good target percentage for moving from presentation to acceptance? Patel says that percentage is a variable number depending on the practice and how many patients are being seen, but he does favor quality over quantity.

“You shouldn’t set any kind of quantity, or time limit, or minimum or maximum,” he says. “It should be based on individual cases. You have to accommodate for that.”

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