Nurse in green scrubs explaining x-rays to father and son duo in a treatment room

Patient Decision Making: Saying 'Yes' to Care

Mar 21, 2017 

Author: Sharon Boyd, RDH, BS

How many times have you reviewed a care plan with your patients, only to hear them say, "I'll think about it?" The patient decision making process is a complex one. It depends on factors that include their insurance coverage, socioeconomic status, whether something about their smile is bothering them, and what they consider to be good oral health.

When it comes to persuading patients to accept a care plan, dental hygienists should be sensitive to the factors that help determine patients' care choices. Check out these tips to avoid the dreaded "I'll think about it," and get more of your patients to say "yes" to treatment.

Co-plan and Co-diagnose

One of the best ways to influence a patient's case acceptance rate is to encourage co-diagnosis and co-planning. Talking through treatment plans with a dental hygienist and a dentist educates patients and allows them to make well-informed decisions. If your patients still need some persuading, there are a few things you can do during their appointments that may encourage them to agree to treatment.

Visual aids are key. Explaining what decay looks like is not as powerful as seeing what decay looks like. Dental Economics suggests using intraoral cameras to capture enlarged intraoral images. If they decline care, print the photos and send them home with them for their review. Additionally, show your patients and compare their current and previous X-rays side-by-side on the computer monitor. That way patients can see how the problem has worsened in the short time since their last appointment.

When patients understand the severity of their condition, they may be more compelled to act. Discuss the symptoms of oral diseases and their stages of development. Also explain the tools you use during their appointment. Use informative periodontal flip-charts or the Gum Health Physical tool to show what probing depths mean, prior to conducting a full mouth probing. Allow the patient to hear you call out these numbers as you go along.

Outline the Consequences

If treatment is delayed, dental conditions typically get worse. Most people feel that if something doesn't hurt, it's not worth fixing. For example, gingivitis is reversible, so patients may not take this common condition seriously. Warn patients that gingivitis can develop into periodontitis, which is much more severe.

You need to show patients how a minor or moderate condition today could evolve into a complex situation a few months down the road. Share some numbers regarding treatment costs, and explain why it's worth the patient's while to save money as well as his or her irreplaceable tooth structure.

Do the Math

A fair understanding of dental insurance policies and benefits is a must for any dental hygienist presenting a treatment plan. Get the numbers straight prior to recommending the appropriate therapies so that you can address the costs involved, and your patient's budgetary constraints and health needs.

Determine the following:

  • Any deductible amounts that have yet to be reached.
  • Percentage of estimated coverage on the different levels of treatment compared to more advanced procedures due to delayed care.
  • Now vs. later costs that are involved in preserving their dental health. Show patients how early treatment saves money.
  • Additional financing options that could help patients save money by getting treatment completed soon, as opposed to when they "have the time."

For example, paying out of pocket for scaling and root planing may help your patient avoid an expensive referral later to a periodontal specialist for more involved treatment that could potentially include surgery. Once the new year starts, insurance plans reset. The beginning of the calendar year is one of the best times to take advantage of benefits, especially if treatment must be completed in stages.

Even if you're not the main dental professional providing the treatment consult, a familiarity with this information will aid in your handoff during the patient decision making process, further emphasizing the need to improve oral care and case acceptance rates.


  • Conform your treatment recommendations to the budgetary and health needs of the patient.
  • Co-diagnose and co-plan to increase the chance of case acceptance.
  • Persuade patients to get treatment sooner rather than later to improve their oral health and reduce out-of-pocket expenses.

Why It's Valuable

Insurance coverage resets at the beginning of the year. Now is the time to get your patients thinking about completing their treatment rather than waiting until something hurts and costs them more to fix. Be sensitive to your patients' budgetary and health needs while you try to get them to say "yes" to treatment.

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