5 Steps to Change Patient Behavior and Stop Delayed Care

Dr. Cindy Roark


Delaying dental care is not a new trend for dental patients during the pandemic. We’ve all heard how much anxiety patients can have about going to the dentist. However, the temptation to push off dental care did get prodigiously worse during the last year of lockdowns and COVID-19 fears. As we return to a more normalized state, patients that delayed care are returning to offices once more. The unfortunate case is that they are usually returning to deal with an immediate acute problem, like tooth pain or a broken crown. Whether their hesitancy to cross the dentist’s threshold comes from COVID fears or a deeper-rooted reluctance, these patients finally do darken their providers’ doorsteps. This gives dental providers a unique opportunity to educate patients on the perils of delayed care and encourage the patient to change their behavior. In essence, it is our job to convey that dental problems only get worse, not better. They become more extensive and more expensive. And neither the dentist nor the patient wants that to occur.

As clinicians, our chairside manner will make or break how patients respond to these conversations. The procrastinating patient provides a critical opportunity to guide patients towards better oral health. In terms of motivating action and decreasing patient-level fear, here are five steps we practice at Sage Dental to best engage patients in productive care conversations and successfully influence their dental behaviors moving forward.

Step 1: Engage through Teledentistry

Connecting with your patients via non-threatening virtual appointments is the quickest way to ease the stress of a return to the dental office after a long hiatus. Those appointments, whether real-time or asynchronous, convey a lot about your willingness to help and overall lack of judgment for their state of oral health. Patients love it, particularly new patients, which starts the process of getting the patient to pursue treatment.

Step 2: Transform the in-office experience to reflect co-discovery

Utilizing newer technologies, such as HelloPearl’s artificial intelligence Second Opinion platform or Dental Monitoring’s SmileMate virtual consultation iPhone scan, to give your patients a tech-forward, unbiased, and pain-free peak into their oral health condition can go a long way toward lessening the anxiety of a return to care. Fear of judgement is another valid fear that patients experience. Using such methods creates an unbiased assessment, which looks a lot less like a dentists’ judgment or “opinion.” Utilizing these AI iPhone scanning technologies is as simple as taking a selfie. And let’s face it, patients love selfies. Changing the patient’s perception of the visit changes the overall chairside experience into something far less threatening and less open to interpretation.

Step 3:  Take it in bite size pieces

First, we must address the immediate pain or problem the patient is experiencing. Avoidant patients have likely experienced days to months of acute pain or discomfort, so it is important to spend the bulk of the appointment addressing their immediate concerns with compassion and clinical precision. Providers know this. But the temptation is always there to share the entirety of dental disease that we see. Patients are not going to be receptive to any home health or in-office best practice messages their providers are sharing until they are out of pain. At Sage Dental, we make a point of building a solid foundation of patient-provider rapport using innovative new technologies and phased goals, which will ultimately help us get important messages across later.

Step 4: Plan ahead together: what got you here won’t get you there

Once the patient is comfortable, take the time to reflect on their oral health and share the correlations between overall health. Walk through what caused the issue they came in for. Was it a direct result of neglected or delayed care? Would coming in for the recommended semiannual appointments have caught this issue before it became debilitating? In most cases, the answer is yes. 

Once the patient has a clear understanding of the past behavior that brought them to this point, it is the perfect segue to discuss the current state of their oral health. Just because you as the provider dealt with their immediate oral care needs does not mean that their oral health is 100% restored. Now is the time to discuss any other lesions you and the other dental providers have observed in their mouth that are likely to result in future pain or issues if the patient continues to delay care. However, our chairside demeanor is critical to conveying this in a non-judging, forward-focused way. We can’t change yesterday for the patient, but we can certainly improve tomorrow with continued care.

Rather than dictate the patient’s best course of action (something that is sure to alienate them and discourage changed behavior), invite them into a conversation about making a plan that works forthem. Start by giving the patient a big-picture view into the state of their oral health and describing what might become an issue later, while also complimenting them on what they are doing right. In my experience, many providers neglect to point out the positives, and they nearly always exist. Make sure the patient clearly understands that they have options: different treatment plans can be tailored based on the patient’s aesthetic and financial expectations. At Sage Dental, we’ve found a great way to share this information with patients is by utilizes newer simulation technologies, and in turn, they often share these images on social media.

Step 5: Share cautious optimism

Finally, it is important to end with caution and optimism. Dental providers have a duty to communicate the seriousness of delayed care: the patient could wind up in the same (or more) pain than what forced them to seek dental care in the first place. Reminding the patient where the day started, the pain or issue they were experiencing (and would like to avoid moving forward) can be an effective tool to prompt future change. Remind the patient that without implementing a treatment plan, their oral health challenges will persist. Share how much you as their provider want them to never experience “a day like today again.” End by reiterating your hope that they will work with you to ensure that does not happen, and highlight your confidence that their dental experience will be a positive one as you implement the agreed upon treatment plan.

Whether dentists face another pandemic lockdown or not, patients will continue to find reasons to delay their dental care. As a result, even when the pandemic is long behind us, dental providers will be working to address patient hesitancy and the negative oral health consequences of delayed care. From COVID-clench to broken teeth to periodontal disease progression due to delayed care, clinicians will need to leverage excellent chairside manner to build positive rapport with patients. Only through innovative new technologies, strategic communication and strong relationships will patients be persuaded to change their behavior and ultimately elevate their oral health for the better long term.


Dr. Roark is the senior vice president and chief clinical officer at Sage Dental, responsible for overall clinical leadership, including enterprise-wide clinical strategic planning, developing and improving clinical protocols, researching new technologies and services, overseeing quality assurance, and providing professional development opportunities to 500 clinical team members and over 65 supported dental practices. 


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