The Dental Cases That Haunt Us: The Role of Communication in Addressing and Avoiding Mistakes

A great misconception people have about success in business, and success in general, is that you never make mistakes. This is absolutely not true. With 32 years in private practice, I can confidently say I have made every mistake in the book. The true key to success and growth is not avoiding mistakes altogether, but making sure you do not make the same mistake twice. Learn from your mistakes and make changes to your approach. If you do not learn from a mistake, it becomes a failure.

I once had a patient who was a hockey player. He crushed two of his front teeth, and they needed to be extracted. I discussed several treatment options with him, and we ultimately decided to replace the teeth with implants. It seemed simple enough, so I chose not to meet with the oral surgeon beforehand.

When the patient returned from the procedure, the implants had been placed where the bone was, too high up in the vestibule. It was an aesthetic nightmare, something I did not anticipate. The oral surgeon did not contact me when placing the implants, and in that moment, it would have been easy to start pointing fingers and blame the specialist for the error. But at the end of the day, that patient was my responsibility.

I failed to meet and communicate with the oral surgeon to ensure everything was aligned before the procedure. From that experience, I learned an important lesson: with complex cases, you need to meet with the specialist ahead of time. In fact, it is critical to assign someone from your team to manage these cases from start to finish. That person should be responsible for making sure everyone involved—the patient, the team, and the specialists—is on the same page.

I recall another case involving a senior citizen who fell and knocked out four teeth. We carefully reviewed all treatment options, but due to financial constraints, none of the ideal solutions were feasible. Together, we found an option that met the patient’s wants and needs while staying within his budget.

However, when the patient’s family learned about the procedure, they returned upset and concerned about the longevity of the solution. I explained clearly that the patient had a $15,000 problem and that I was recommending a $1,500 solution that would allow him to continue his social life at the senior center. Through our conversations, I learned that he deeply missed attending social events due to embarrassment about his smile.

When we reflected on the situation, the treatment itself was appropriate and the patient fully understood and agreed to it. The issue was that we failed to clearly communicate expectations with all stakeholders involved. That miscommunication led to unnecessary frustration and concern.

Miscommunication: The Root of Mistakes

These two cases highlight a major lesson: 95 percent of mistakes are rooted in miscommunication. They stem from a lack of crystal-clear communication between yourself, your team, and your patients.

As a practice, you must become an expert at communicating. This includes communication with your team through meetings and internal chat tools, communication with your patients, and truly understanding your patients’ wants and needs. There are few things worse than completing what you believe is a great case, feeling like you knocked it out of the park, only to discover the patient is unhappy.

Miscommunication is almost always at the root of mistakes, which is why it is essential to put processes in place that support effective communication. Your team needs to be trained in communication skills that help identify potential problems before they occur.

To build an innovative team, you need innovative solutions. This includes leveraging communication technology and automation to simplify tasks such as appointment reminders, payment collection, and insurance verification. When these tasks are streamlined, your team can spend more time face-to-face with patients, engaging, listening, and building trust.

Communicating With Patients

I have found that asking the right questions during patient discovery helps eliminate many potential mistakes. I use the following ten questions during new patient discovery and consistently throughout the treatment process:

1. Did you have any trouble finding the office?

2. Who can we thank for referring you to me?

3. How can I help you? Tell me more.

4. How does that make you feel?

5. What did your last dentist tell you?

6. Why now? Why did you come in today versus waiting?

7. What are your long-term goals for your health, teeth, and smile?

8. Who else has input in this decision?

9. Do you have a budget?

10. How soon would you like to be finished?

Dive into these questions and let the patient’s answers inspire more questions. Dig deeper. When used correctly, these questions help uncover what the patient wants, what they need, and their expectations and fears.

Try to ask all of these questions. You never know which one will be the winning question, the one that inspires an answer that prevents problems down the road. In the end, it is always better to ask questions than to make assumptions, because assumptions set the stage for miscommunication and future cases that will haunt you.

Patients are unhappy when their expectations are not met, whether related to aesthetic outcomes, financial commitments, or other factors. You need to consistently seek to understand their expectations through targeted questions and, when appropriate, help patients adjust those expectations. When done properly, you will not only meet expectations, but exceed them through both results and outstanding patient engagement.

If you discover that you cannot meet a patient’s expectations—either because the results they want are beyond your skill set or they are unwilling to adjust their expectations—you have identified a patient who may be better served elsewhere. Do not set yourself up for failure by accepting a case that is not the right fit.

After Dropping the Ball

You can try to avoid mistakes, but it is equally important to know what to do immediately after making or recognizing one.

First, stop immediately and inform the patient. No excuses. No justifications. Communicate clearly and openly. Present options to remedy the situation, and if the mistake is yours, own the fix—even if that means financially compensating the patient.

Document your mistakes and develop processes to prevent the same issue from happening again. Most importantly, never try to hide a mistake or deceive a patient. Patients place their trust in you, and if you want to maintain that trust, you must demonstrate honesty, even when things go wrong.

When you cut corners or fail to take responsibility, those cases—and patients like them—are the ones that truly come back to haunt you.