Dental practices: a treatment plan that doesn't stop after the first visit

A patient comes back after eighteen months, in pain. The tooth causing the trouble was treated before, and a crown was agreed as the next step. She never came for that visit. First she was too busy, then the appointment needed moving, then nobody moved it. Now the work starts again, only harder and more expensive for both sides.

The case is made up for this article. But almost every practice has records that show what was done and say nothing about what was left.

The record keeps what was done, not what was agreed

Every procedure goes into the patient record: the date, the tooth, what was done. That is a record of what happened, and it has to exist. Treatment, however, is agreed in advance. After the examination the patient hears a plan: this first, then that, then a third thing in a few months. That plan usually lives in the dentist’s head, on a sheet the patient took home, or in the words “give us a ring to book”.

When the plan isn’t written down as a plan, the practice can’t answer a simple question: how many courses of treatment have started and not finished? Reception can’t see it, the dentist remembers some of them, and the patient often thinks it’s all done once the pain goes.

The treatment plan as a list of steps

A plan doesn’t need to be a complicated document. Each step needs just a few details:

• the tooth or area, and what is being done
• the order, and what has to be finished before this step
• how long to wait between steps, when that depends on healing or the lab
• who does the step, when the practice has more than one dentist
• the price the patient was told and accepted
• the status: done, booked, or not yet booked

The last one matters most. “Not yet booked” is where treatment stalls. When those steps appear on one list, with the date the previous step was done, reception has a clear job: ring the patient whose next step was due a month ago, instead of guessing who to call.

The same list helps the dentist. Before the patient sits in the chair, the dentist sees not only what has been done on the tooth, but what comes next in the plan and what the patient was told about the price. The conversation about the next stage doesn’t rely on anyone’s memory.

An appointment is more than a time slot

A check-up is short. A root canal or a wisdom tooth extraction takes much longer and needs different preparation. When the diary only says “ten o’clock” and not what is being done, the day is built on guesswork. One longer procedure pushes everything after it, and patients sit in the waiting room.

When the appointment is tied to a step in the plan, the software knows roughly how long the work takes, which chair it needs and which dentist does it. Reception doesn’t have to remember how long everything takes for each dentist. It is set once and adjusted when the estimates turn out to be wrong.

The lab is part of the schedule

For a crown, a bridge or a denture, part of the work leaves the practice. An impression or a scan goes to the dental lab, and the work comes back days or weeks later. The patient is booked for the day it is due to arrive.

This is where a mistake costs twice. The patient takes a day off and comes in, and the work hasn’t arrived. The dentist has lost the slot and the patient has lost patience.

When the lab order is recorded against the step in the plan, with the date it was sent and the date the work was promised, the software can pick out, a day ahead, the appointments whose work hasn’t arrived yet. The lab gets a call in the morning, and the patient hears in good time, before sitting down in the chair.

Work between the practice and the lab is like any work that sits between two parties: the doing is quick, the waiting is long and invisible. There is more on that in From enquiry to delivery: how often do the same details change hands?

X-rays stay in their own software

X-ray units and scanners usually come with their own imaging software. There is no need to replace it. It is enough that one click from the patient record opens that patient’s images, or, where the equipment allows it, that the image is stored against the patient and the tooth. The dentist then isn’t searching another program by date while the patient waits.

Who gets to see the medical history

Medical history, allergies, medication and X-rays are health data. Data protection rules place them among the most sensitive kinds of personal data. In the software, that means reception sees appointments, plans and prices, while the medical history and clinical record are open to the people who need them for their work. There is a record of who opened what. And the data doesn’t travel by message on personal phones, even when it’s urgent.

The plan is entered while the patient is still in the chair

The biggest gain comes from entering the plans of patients currently in treatment first. Old records can wait. The dentist or the nurse enters the plan while the patient is still there, because that is when everyone knows exactly what was said. Entering it at the end of the day, from memory, is already retelling.

A text reminder before an appointment is useful and easy to set up. But a reminder only goes out for an appointment that exists. For a step that was never booked, there is no reminder.

How many courses of treatment have stalled halfway at your practice? If you can’t answer without going through the records, tell us how you book appointments and keep plans today. Please don’t send patient data; a description is enough. We build systems where the treatment plan drives the diary and the lab orders as part of our CRM and ERP system design and build work.