Raising Case Acceptance in Private Dental Practices

December 11, 2025

Economic uncertainty prompts patients to scrutinize dental expenses more closely, intensifying pressure on the acceptance of treatment plans.

This article explains how to define and measure case acceptance, what common benchmarks look like, and how private practices can protect and grow case acceptance when patients are concerned about financial matters.

What exactly is “case acceptance”?

At its core, case acceptance refers to the percentage of recommended treatments that patients actually proceed with.

Most practices calculate it in one of two ways:

• By cases or patients: Number of Accepted Cases/Total Number of Presented Cases.
  
  
• By dollars: Total Dollar Amount of Accepted Treatment/ Total Dollar Amount of Presented Treatment.
  
  

Many consultants now favor a dollar-based definition because a "yes" to a single filling and a "yes" to a full mouth rehabilitation are not equivalent decisions. Segmenting your KPIs is critical because it recognizes that different patient groups and case types face distinct decision-making factors and barriers.

This segmentation provides greater clarity, highlighting exactly where acceptance challenges exist, allowing you to implement targeted improvements.

For example, useful breakdowns include:

• New versus existing patients.
  
  
• Preventive or basic versus major or comprehensive care.
  
  
• Insurance-heavy versus fee-for-service patients.
  
  
• Same day starts versus scheduled later.
  
  
• Provider-level acceptance.
  
  

Modern dental analytics platforms that integrate with your practice management system enable easy segmentation and display trends by provider, treatment type, and patient group.

Industry benchmarks: Where do most practices actually land?

Different studies and vendors use different definitions, but taken together, several consistent patterns emerge across the United States' general practices.

Overall practice case acceptance:

• Many average or struggling practices fall within the 35-55% range when measured by cases or dollars.
  
  
• Analytics and benchmarking groups commonly describe average practices as around 50-60%, strong performers as 70-80%, and exceptional practices as above 80%, when the definition is tight, and systems are mature.

New versus existing patients

Data from large datasets consistently shows a gap between new and established patients,

• Existing or returning patients often accept 40-50% of recommended treatment, with strong practices at 70% or higher.
  
  
• New patients accept at much lower rates, often 25-35%, and sometimes much lower for large or elective cases.

By treatment type

Acceptance also varies by the size and nature of the case:

• Preventive care, such as exams, radiographs, and cleanings, often achieves acceptance rates of 80-90% and higher.
  
  
• Basic restorative care, such as fillings and single crowns, typically falls within the 70-80% range.
  
  
• Major and comprehensive care, such as implants, extensive prosthodontics, or full mouth rehab, more commonly sees acceptance around 60-70%, and sometimes lower in economically stressed communities.

Since the economy disproportionately affects larger, higher-fee cases, it is wise to track a separate case acceptance KPI for treatment plans exceeding a threshold, such as $1,500 or more.

Segmenting these cases allows you to monitor trends and adapt your approach, as they often require different strategies for patient communication and financial planning compared to smaller cases.

Putting the benchmarks together for a private practice

For a general, privately owned practice using a dollar-based definition and excluding hygiene-only visits:

• Below about 45%, the practice is leaking both revenue and patient health benefits.
  
  
• Roughly 50 - 65%, typical range, workable but with meaningful upside.
  
  
• Roughly 65 - 80%, strong, especially if that includes larger multi-tooth cases.
  
  
• Above 80% on well-defined, non-preventive treatment dollars, elite performance.
  
  

The point is not to obsess over whether you are at 63% or 67%, but to measure consistently, compare against your own baseline, and build a plan to improve.

Why case acceptance matters more when money feels tight

Recent survey data indicates that many patients delay or avoid dental care due to the cost. A significant share of adults report skipping or postponing dental visits due to concerns about the cost, even when insurance benefits are available. Many also report that their dental problems worsen when care is delayed.

At the same time, broad consumer dental spending has risen modestly, while many dentists report feeling less busy and are uncertain about the near-term dental economy. That tension tells you a lot; patients are still spending, but they are choosier.

They are more likely to:

• Say yes to lower ticket, single tooth care.
  
  
• Defer comprehensive or elective treatment.
  
  
• Shop around or delay if they do not clearly understand the value or the financing.
  
  

In that environment, case acceptance becomes a leading indicator of practice resilience. A strong system protects your production, maintains a healthy schedule, and reduces the number of patients whose oral health deteriorates because they feel they cannot afford care.

Step 1: Ensure your case acceptance KPI is accurate and visible.

Before attempting to improve case acceptance, ensure that you are measuring it in a manner that accurately reflects reality in your practice.

A practical starting framework is:

1. Track two primary case acceptance KPIs by dollar value.

2. Overall case acceptance, all presented treatment dollars, excluding hygiene-only visits.

3. Case acceptance for treatment plans above a chosen fee threshold, for example, $1,500 or $2,000.

4. Segment both of those by:

• New versus returning patient.
• Provider.
• Use of third-party or in-house financing versus no financing.
  
  

5. Use a consistent time window, for example, accepted within 90 days of presentation, so you do not overcount or undercount cases that are accepted later than average.

Analytics platforms and some practice management systems support this kind of segmentation, highlighting case acceptance as a core KPI for practice growth.

Once you have a stable measurement, set clear goals that acknowledge the economic climate, such as improving overall acceptance by 5 to 10 percentage points and large case acceptance by 10 to 15 points over the next 12 to 18 months, rather than chasing a blanket 90% target.

Improving case acceptance when patients are financially anxious

Economic uncertainty does not mean patients do not value their oral health. It means they need more help aligning the care they need with their financial and emotional bandwidth. The most effective improvements usually come from five areas: communication, financial design, process, team, and follow-up.

Upgrade the case presentation itself.

The success of any dental practice is directly related to how often patients accept recommended treatment, and a choreographed, visual case presentation significantly improves acceptance.

In a tight economy, this matters even more:

• Anchor the conversation in the patient's goals first, comfort, appearance, longevity, and lifestyle.
  
  
• Use visual aids, such as photos, intraoral images, and models, to help patients clearly see the problem.
  
  
• Explain the consequences of delay in concrete terms, such as future cost, more invasive procedures, time off work, or risk to overall health.
  
  
• Translate clinical language into everyday terms and confirm understanding by asking the patient to explain the plan back in their own words.
  
  

Patients who genuinely understand the consequences of doing nothing are more likely to prioritize treatment, even when finances are tight.

Make money feel navigable, not mysterious.

Most research on delayed dental care identifies cost and a lack of clarity about costs as the primary barriers. Economic uncertainty magnifies that anxiety, so your financial systems need to be as transparent as your clinical care.

• Provide a clear, written estimate that separates the total fee, the expected insurance benefit, and the realistic out-of-pocket cost.
  
  
• Offer tiers or phases when clinically appropriate, including ideal treatment, staged treatment, and a minimum approach to stop progression, along with honest timelines and risks for each level.
  
  
• Normalize financing and membership options as part of the conversation, not as an awkward afterthought, since third-party financing and in-house plans can reduce perceived cost barriers.
  
  
• Train your treatment coordinator to confidently discuss monthly payments, not just lump sum fees, especially for cases above your high-value threshold.
  
  

The goal is not to sell dentistry; it is to make needed care genuinely doable within a household budget that already feels stretched.

Prioritize comprehensive value over single tooth volume.

A very high percentage of general dental appointments are single-tooth treatments, which means many practices hit production goals through sheer volume rather than through comprehensive case planning.

In an inflationary environment, that model is risky; every low-value visit still carries full overhead.

Instead:

• Use your analytics to identify how often you present and complete comprehensive, multi-tooth plans versus single tooth fixes.
  
  
• Track a separate case acceptance metric for multi-tooth or full-quadrant treatment, because this is often where economic anxiety suppresses acceptance the most.
  
  
• Recalibrate your exam and case presentation so that comprehensive first, staged if needed, becomes the norm, instead of defaulting to the one tooth that currently hurts.

Raising the average case value, without sacrificing ethics, allows you to maintain profitability with fewer, better-planned visits, which is especially important when patient demand softens.

Not sure where to start? Contact us today!

References

American Dental Association, Health Policy Institute. (2024). National trends in dental care use, dental insurance coverage, and cost barriers to care [Research report]. American Dental Association.

American Dental Association, Health Policy Institute. (n.d.). Coverage, access & outcomes [Webpage]. Retrieved December 2, 2025, from ADA

Delta Dental Institute. (2022). How Americans are prioritizing their oral health during COVID 19 [Survey brief]. Delta Dental Institute.

Delta Dental Institute. (2022, December 8). Nearly half of Americans will delay dental care due to inflation [News alert]. Decisions in Dentistry.

Kaiser Family Foundation. (2023). Access to adult dental care gets renewed focus in ACA marketplace proposal [Issue brief]. KFF.

Kaiser Family Foundation. (2025). Health care costs and affordability [Issue brief]. KFF. KFF

Synchrony. (2023, October 4). Americans may forgo dental treatments due to cost, risking overall health [Press release]. Synchrony Financial, CareCredit.

Synchrony. (2023). Dental lifetime of care study, Understanding the value and cost of dental care [Research report]. Synchrony, CareCredit.

CareCredit. (2025, May 13). Preparing patients for the cost of dentistry [Article]. In Preparing patients for the cost of dentistry. CareCredit.

Money Magazine. (2023). Over 90 percent of Americans may delay dental care due to high cost [News article]. Money.

American Dental Association, Health Policy Institute. (2019). Main barriers to getting needed dental care all relate to affordability [Research brief]. American Dental Association.