Incremental Revenue – A Series – Part 6 – Dental 1 of 2



This installment in the Incremental Revenue series will deal specifically with potential dental incremental revenue areas.  This aspect of incremental revenue is considerably more complex than that of hygiene incremental revenue.  While hygiene services are pretty much the same from one office to another, the dental services provided by one dentist can be very different than the dental services provided by another.  We are going to focus on incremental revenue sources that would apply to almost any office.  Changing the service mix to primarily high-value discretionary services would generate more incremental revenue but would not be a practical strategy.


While finding incremental dental revenue is easy, it is also hard work.  After thirty-five years of working exclusively with dentists, I know that every practice has some low-hanging dental fruit, but I also know that it takes some work to get it.  I also know that getting the low-hanging dental fruit is more complicated than getting the low-hanging hygiene fruit.  My proposition in this installment is the old 80/20 rule that you can get most of the low-hanging fruit for not too much work.  It is a process, and if you follow the process, it will pay off for you, so let’s take a 30,000-foot look at the process.

Supporting Particulars

In the installment on hygiene incremental revenue, we were able to identify the target revenue we were looking to achieve precisely.  It is pretty much impossible to do that for incremental dental revenue.  This is so difficult because dentists have a vast range of services to offer, and the revenue they typically generate will depend on what procedures they usually offer.  We will not look at changing anyone’s favoured procedures other than suggesting that they follow through with the procedures they do like to do.  We will look at the process that all dentists should go through to more effectively provide the treatment that their patients either need or that they enjoy providing.  If a patient needs treatment that anyone dentist chooses not to provide, it behooves that dentist to refer the patient to a dentist who will provide the needed treatment.

There is a fairly simple process that all dentists should follow if they want to ensure that they provide all of the services that they should be.   In very general terms the process is as follows:

  1. Diagnose the disease, dysfunction, or dissatisfaction.
  2. Prepare the right Treatment Plan.
  3. Present the Treatment Plan to the patient
  4. Provide the service.

This is an immense topic largely due to the fact that there are so many options and aspects to incremental dental revenue.  For this reason, I am going to break this topic into two parts.  The first part will deal with the diagnostic aspects of the topic and the second part will deal with treatment planning and case presentation.


“If you do not diagnose it, you cannot deliver it”.  The whole dental service process should start with a thorough diagnosis.  You would not start to build a house without first having plans, and similarly, you should not start treatment without a plan. You cannot have a good plan if you have not diagnosed the situation, be it a problem or a desire for an aesthetic enhancement.

There are many components to an effective diagnostic process. I want to consider five that are either so obvious that they are overlooked, ignored, or not done as effectively as they could be. They are as follows:

The New Patient Exam:

Someone will only be your new patient once, so this is a multifaceted opportunity. To begin with, a New Patient Exam is your first and only first opportunity to make a good impression. Forget about how good your dentistry is; if you don’t make the patient feel welcome and at ease, you will not likely get an opportunity to showcase your dental skills. The ability to quickly build strong rapport is a major cornerstone of any client-based service. Some people naturally develop excellent rapport-building skills. Most people who have great rapport-building skills are not even aware of it. I recently asked a client whose office had over 16,000 active patients how he managed to attract so many patients. He answered that he simply said “Hello” to everyone in reception whenever he walked by. It is not so much what he said but how he said it. At any rate, he had a natural ability to build rapport. If you are not one of these people, the good news is that this is also a skill that you can learn. A Google search of “rapport-building” produces “about 190,000,000 results,” so you should be able to find something that can help you develop better than good rapport-building skills. We talked in an earlier installment about the incremental impact of new patients – with 16,000 active patients, this practice was definitely taking advantage of new patient incremental revenue.

From a dental revenue perspective, the most important aspect of a New Patient Exam is to ensure that you conduct and document a thorough clinical examination. You may not get the chance to do this again – ever. Unlike rapport building, dental diagnostic skill is not something you are born with – you have to learn how to do it. If you think you can learn it on your own, Google has 42,000,000 suggestions for you; however, this is an area where you would benefit from the guidance of a coach. Enhancing your diagnostic skills is a function of who over how. Skilled coaches can more quickly and cost-effectively guide you through the process of enhancing your diagnostic skills than you can do yourself. We have provided some resources at the end of this installment.

Asking the Patient:

Asking the patient what they want seems pretty obvious but is the most overlooked diagnostic tool of all. The reason this gets missed has something to do with how dentists are wired. A recent study at the University of Toronto found that of all the professionals, medical and otherwise (like engineers), dentists were the most ego-strong. In other studies, dentists have ranked very high in measuring their clinical skills and clinical judgment internally. This means that they do not need someone to tell them they have done a “good job.” They just know it internally themselves. The risk with this set of beliefs is that a dentist may get trapped into believing that they know better than the patient what the patient wants. They may indeed know better than the patient what the patient needs but not what the patient wants. Patients are more likely to buy what they want than what they need – hopefully, they are one and the same.

It is important to remember that patients come to see their dentists not only to fix disease and discomfort but also for aesthetic reasons. Even in cases of disease and discomfort, there are usually multiple ways to resolve the patient’s issues.

A very effective question to ask is Dan Sullivan’s “D.D.S. Question.”  The question goes something like this.  “If we were sitting here a year from now (or 2, 3, 4 or 5 years – whatever is appropriate) looking back over the last year, what would have had to have happened in order for you to get the absolute best outcome you could imagine?”  If you ask your patient that question, they will give you all the information you need to provide them with exactly what they want.  If they can’t or won’t answer that question, then it’s likely that they are not entirely committed to the process.  This also does not mean that you can’t discuss options with them, but you should not proceed with anything until your patient give you a clear indication of their “absolute best outcome.”

Recall Examinations:

There was a time when patients could receive a Complete Oral Examinations (COE’s) every three to five years, and many dentists used this opportunity to refresh their treatment plans.  When this was possible, the Recall Exam took a bit of a back seat to COE’s.  Dentists knew that they would be able to re-assess the situation in the worst-case scenario at some point in the future.   Given that COE’s are not as accessible as they once were, it propels the once lowly Recall Exam to the head of the class.

Recall Exams should be a process of joint discovery and analysis involving the dentist and the hygienist.  It is not the hygienist’s role to prescribe dental treatment, but it is undoubtedly within their responsibility to observe disease and dysfunction and share that with their dentist.   It is appropriate for hygienists to explain procedures recommended by the dentist to the patient in many cases.  A dentist only has a few opportunities to diagnose potential treatment and as such, they should take advantage of all of those opportunities.  The Recall Examination is one of those opportunities which should not be missed.

Diagnostic Aids: 

At one time, eyeballs and explorers were the dentists’ best diagnostic tools.  A lot has changed since those days.  Today there is a wide and comprehensive offering of dental diagnostic tools.  Every specialty and general dentistry has a long list of some old and some new tools to assist the diagnostic process.   In some cases, new diagnostic tools make the diagnostic process easier, while in other cases, they can help you discover otherwise undetected issues.  Our objective is to identify sources of incremental revenue, so our focus should be on diagnostic tools that will help you discover otherwise undetected treatment areas.

A quick search of Google cones up with 13,500,000 responses for “dental diagnostic aids.”  My point concerning new dental diagnostic aids is that every dentist should integrate at least two new diagnostic protocols into their practice every 12 months without wasting their time.  Technology changes very quickly, and the equipment or protocol you were using five years ago may still work, but it may also be obsolete.   If you bought an iPad five years ago, it would still work today but not as well as the one you bought last month.  This holds true for virtually anything digital.


While we often present hygiene departments as a great place to look for incremental revenue the place that holds the greatest source of incremental revenue is the dental department.  It may be harder to dig out but its potential is greater than that found in the hygiene department.  The incremental revenue opportunity in a hygiene department is easier to find and actualize however it is finite – at some stage, you will have maxed it out.  The incremental revenue possibilities in the dental department are almost infinite depending only on the dentist’s desire to learn and expand.   The nice thing about expanding your dental revenue is that you increase your value to your patients as you expand the breadth of your service provision.


For information about coaching services specifically designed to help you capture all of your incremental dental revenue, please contact Linda Anderson at  Linda heads the dental coaching team at HD Dental Coaching.  If you would like more information about this or any other articles in the Incremental Revenue series, please contact Derek Hill at or If you would like to receive a posting notice for all future articles on this topic or any others, please fill out the “Subscribe” input box and click the submit button. For other articles by Derek Hill, you can visit the Hill Kindy Practice Sales website at