How to Move Patients From Basic Treatment to Comprehensive Dentistry

Intro: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice—one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. Uh, we have a great podcast episode for you today. It’s titled How to Move Patients From Basic Treatment to Comprehensive Dentistry. You know, this is a challenge that every dentist faces, and we thought we’d, uh, share some information that might help you move more of your patients along, uh, to accept more comprehensive care. I think you’ll enjoy this episode.

Hey, before we get to that podcast episode, two announcements to make. Uh, first of all, we have an upcoming Thriving Dentist event. Uh, this is actually a two-hour webinar. It’s part of our Culture First Dentistry series. Uh, it’s happening on February 24th. Uh, the particular title of that webinar is How to Build Teams That Thrive. Uh, you know, we’ve had a lot of requests from, uh, our listeners about team building.

And so we decided to host this particular webinar, uh, in the Culture First Dentistry series, uh, about how to build teams that thrive. Uh, it’s on February 24th, uh, starts at 6:00 PM Eastern Time, and it’s a two-hour webinar. Uh, to register for that, go to thrivingdentist.com/events.  Um, there’s no tuition for this webinar. It’s two hours long. There’s no tuition. Uh, however, you do need to register through thrivingdentist.com/events  and grab your seat if you’re interested in, uh, how to build teams that thrive. This is the event for you.

Now, my next announcement is we have a long-time friend of mine, Dr. Chris Ramsey. Um, Chris and I have known each other for many, many years, and, uh, I’m very grateful that he has joined us for a clinical tip. And his particular clinical tip is his go-to workflow for mixed dentition lower arch cases. By mixed dentition, uh, Chris means that there’s some natural teeth involved as well as implants, and he’s gonna share with you, uh, his go-to workflow. Uh, Chris is an amazing clinician, and, uh, this workflow will likely be very, very useful for you.

No further ado, here’s Dr. Chris Ramsey—his go-to workflow, uh, for mixed dentition lower arch cases with implants.

Dr. Chris Ramsey: Hey guys, Chris Ramsey from Ritter Ramsey. So I get a lot of questions about what we’re about to do here. So we have a case that we’ve finished the upper in its entirety, and we’re about to attack the lower. The lower is a mixed case of natural teeth and implants.

So what I want you to see here is, if you look at the iTero, the upper was completed. So let’s go ahead and take that away. And what you see now is the lower that we’re gonna send to get designed and waxed. And here we have our Neoss abutments and scan pegs. You could be using any implants with scan bodies—whatever your preference is. We went ahead and scanned that.

Now, what we’ve asked them to do is attack this in one of two ways. A lot of people just have abutments made so that you can start your preparation and then do all your preps and make your temps right over both your abutments and your prepped teeth.

Dr. Chris Ramsey: But what we’ve opted to do many times, which works really well—what we want to highlight here—is have the lab already make us a screw-retained temp at the new vertical. And then we will have all these teeth to prep. And when we make our Luxatemp temps against here, it will represent the new vertical.

So go ahead and close down. As you can see, that comes together really nicely. And if we chin up, you’ll notice how much space we have under there—that’s gonna represent and be filled in by the new vertical dimensions. So, chin down.

So yes, you could have abutments made, but you still have to make your temps. What I like about this option—go ahead and up—is when we get ready to come in with our matrix, we’ll have a positive stop, which will allow us to seat that matrix and not have it floating around because there’s no positive stops, ’cause everything’s gonna be prepped.

So we create a positive stop on this side, making our temporization on the left side up to number 27 a lot easier. So, multiple ways to attack this case, but we wanted to show you—go ahead and bite down. Very predictable.

So when you guys do this step, go ahead and make little micro adjustments you need to, to really hone it in on the right side before you start prepping to get your vertical just perfect. Make sure there’s no interferences and you’re up and running.

Naren Arulrajah: Hello everyone, this is Naren, your co-host, and the topic we are discussing today is How to Move Patients From Basic Treatment to Comprehensive Dentistry. Hope you enjoyed that clinical tip from our friend Dr. Christopher Ramsey. Uh, Dr. Ramsey, as many of you know, is an expert in his field and, uh, we’re so glad he’s able to contribute. If you have any questions for him, please feel free to reach out to us and we’ll make sure he gets it.

Today’s topic, How to Move Patients From Basic Treatment to Comprehensive Dentistry, is a topic that I know we get a lot of questions around. Um, one of the things I hear, Gary, from many of our mutual clients is, um, the struggle with case acceptance. And case acceptance means—typically—it involves comprehensive dentistry, as opposed to must-have basic dentistry.

You know, "I have a broken, uh, tooth," or, "I have, you know, uh, a cavity and I need to fill it," or, "I’m in pain," right?

Naren Arulrajah: Those are basic dentistry. Comprehensive is where case acceptance is important because it’s not something that the patient can easily see or understand. Like cavity—they get it, you know, they’ve been trained. If you don’t take care of a cavity, it’s gonna get worse. Pain—they understand, right? Broken tooth—they understand, they can see it.

Um, so they often think the problem is how to present treatment. But I know from our experience—mutual experience—you’ve been doing this now for four to six years, working with practices across the country. I see the real issue usually is before we even start getting into treatment and how to treat it—it’s the precursor to that, right?

Case acceptance is not about convincing them, "I’m right and I know what I’m doing." It’s more about helping them realize what they need and getting them to want it, right? As opposed to them feeling like we are trying to sell them something.

Why don’t patients typically move quickly from basic care to comprehensive dentistry? Not only patients, but even practices—why do you think they struggle, Gary?

Gary Takacs: Well, that’s a great question, Naren, and you’re absolutely right that, um, if you make the assumption that it’s all about case presentation, then you’re making some assumption that there’s some magic phrase you could use, right? That would instantly transform the patient to, "Yeah, let’s do this."

So let me back it up. There is no magic phrase. However, there are absolutely some things that you can do to move patients from basic treatment to comprehensive dentistry. Um, and you’re right, Naren, that it really involves many factors other than just the words that we use.

You know, a book that you and I are fond of, written by Cialdini, is the book Pre-Suasion, right? Pre-Suasion. And actually, I’m not mispronouncing that word. If you’re listening, you might think, "Didn’t Gary mean persuasion?" No, no.

Gary Takacs: Pre-Suasion. Yeah. It’s a term that Dr. Cialdini made up. And it’s the idea that consumers can be preconditioned—they can be preconditioned to be open to your recommendations. And actually, that process often happens before they ever arrive in your office.

But I want to back up and talk a little bit about case acceptance before we get back on the topic of pre-suasion. So, the way every dentist was taught case presentation in dental school is fundamentally flawed—fundamentally flawed. In dental school, you were taught: identify a problem, present a solution. Identify a problem, present a solution.

Every dentist, regardless of what dental school they went to, regardless of when they graduated—you know, we have listeners at The Thriving Dentist Show that graduated in the ’80s from dental school, in the ’90s, in the 2000s, in the 20-teens, and now we have listeners that graduated from dental school in the 2020s, right? Mm-hmm. You know, think about that, Naren—that’s five decades. And they were all taught the same thing: identify a problem, present a solution.

And you know, I don’t really have a bone to pick with the way dental schools teach this, because that is something they want you to learn—you know, find a problem and then present a solution. But the real problem, when it’s outside of everyday dentistry or outside of urgent care, is if you are presenting a solution before the patient has any awareness that they have a problem, your voice is gonna fall on deaf ears.

So the key here, and the real key to moving patients from basic treatment to comprehensive dentistry, is to be in relationship with your patients—to be in relationship with them. When you’re in relationship with them…

Gary Takacs: You know, when we’re more on the relational side as opposed to the transactional side, then you’re more likely to have a receptive patient that is interested in what you’re presenting to them. Um, so really the key is to move your practice more on the relational side.

Now, let’s recognize that, in terms of treatment, treatment basically falls into what I would call three different categories.

Urgent care—you know, “I have a toothache, it’s been keeping me awake for three nights.” Urgent care—by the way, your case acceptance percentage on urgent care should be 100%. Yeah, if that’s something you can do, if whatever problem they have is a service you provide in your practice, your acceptance should be 100%.

Naren Arulrajah: Hundred percent. Yeah. Now—

Gary Takacs: The next level, the intermediate level, would be what I would call asymptomatic general dentistry. Asymptomatic general dentistry.

Asymptomatic meaning it doesn’t hurt, and it falls into general dentistry. And what we still see very commonly in 2026, as this is being aired, is patients presenting with old amalgam fillings that maybe have been placed for many, many years, and they’re clearly broken down and really do need to be replaced clinically. Except guess what? Because it’s asymptomatic—guess what, Naren?

Naren Arulrajah: They don’t feel like there’s a problem.

Gary Takacs: They don’t hurt. Yep. Yeah.

And then your case acceptance for asymptomatic general dentistry—our goal that we teach our clients is to shoot for a 70% or above case acceptance for that kind of dentistry.

Naren Arulrajah: Let me ask you this, Gary. A cavity and I need to get it filled—would that come under that category?

Gary Takacs: If it doesn’t hurt. If it hurts, that’s emergency—it’s urgent, right?

Naren Arulrajah: Right. If it doesn’t hurt, like, you know, doctor notices, “Hey, I’m seeing this cavity and if you don’t take care of it, it could become a problem for us”—that’s, uh, and I think—

Gary Takacs: What’s happening is that’s—as long as it doesn’t hurt—it’s asymptomatic. Yeah.

Naren Arulrajah: I think cavity is a classic example, right? Most of us know—at least in my family—that if you see a cavity, you take care of it. You don’t want to let it… you know. Even our kids know that. My wife knows that. I know that. So I think there are some mindsets people have on these things that you have to take care of, even though it doesn’t hurt.

So I guess there, you’re not doing as much convincing. People already are bought into that mindset, so you just have to point it out to them and show it to them so they see it, and then—“Okay, yeah, let’s get it done.”

Gary Takacs: And then there’s a third category, which is comprehensive dentistry, which could be a whole range of things.

Comprehensive dentistry, comprehensive care, complex restorative dentistry—the more complex. All those things kind of fall in the arena of high-value—what I call high-value services, right?

But let’s take the classic case. The classic case would be likely an older patient—an older patient, perhaps late fifties, early sixties and older—that has severely worn teeth. Severely. They’ve worn them down into little nubs.

They’re, um, um, you know, much smaller than they should be naturally, because they’ve worn them down. But they don’t hurt. They don’t hurt.

Now, let me back up, ’cause we’re gonna tie marketing into this. If a patient is seeking out complex restorative dentistry—if they’re seeking that out—and you have somehow succeeded in your marketing to let people in your community know that you are the office to go to for this complex restorative dentistry, and that can be done through lots of different marketing strategies—if they’re seeking that out, case acceptance is easier.

Gary Takacs: Uh, for example, a lot of dentists will—once they get through the introductions with patients and they begin to get to know each other—they might say, “Naren, what brings you in today?” Right?

Now imagine the patient says, “Well, doc, um, my wife commented that my teeth are really nubby and they make me look older, and, um, I want to do something about that.”

Now we know there’s interest. Remember I said, the problem with the dental school model is: identify a problem, present a solution. However, you don’t know if there’s any interest.

If the patient presents with an indication that they’re interested in this, then you’ve got a green light to present comprehensive care, because they’re asking you for that. They’re asking you for that. Does that make sense, Naren?

Naren Arulrajah: Yes. And I think a lot of patients today—you know, since COVID and since, uh, tools like Google were invented—come to doctors asking, for example, “I know that my mom or my dad died of dementia, and I know his sister died of dementia. And I’ve heard doctors talk about—at least my mom’s sister—she had advanced gum disease. And they said that could be one of the reasons that made her dementia…”

Gary Takacs: There’s a link. There’s a link around infection in your gums to dementia.

Naren Arulrajah: Exactly. So, I’m interested, I’m curious. I go to my doctor and I start asking them. Or I just go to Google and start asking Google. And Google starts showing me dentists who treat dementia—you know, who treat gum disease and who have made the connection between dementia and other kinds of diseases and gum disease and so forth.

So I’m like, “Oh yeah, this doctor is aware of it. He shows up on Google search”—especially with Google AI and stuff—and I go to that person because I know he’s thinking the same way I’m thinking.

We kind of identify people who are thinking like us. And I think you said it best, which is: this idea of who can win that game of comprehensive care is the one who is in relationship.

So it’s kind of like Stephen Covey said it, right? He said, “Before you can withdraw from an emotional bank account, you need to deposit into it.” Before you can get them to listen, they need to know you listen to them, you care about them, you—you know—you are here to take care of them.

That’s the relationship piece, right? They know your goal is to make them successful or help them achieve their dreams.

Gary Takacs: Now, there’s another fundamental point that we need to inject here. Yeah, fundamental point is that, um, you have to look at the audience—who your patients are. If a patient is choosing you because you take their insurance—if that’s the only reason why they’re choosing you—it may be a steep uphill climb to talk to them about comprehensive care, because likely they’re only interested in having things done that are covered by their insurance.

"I only want to have things done that are covered by insurance." And there’s a lot—and it saddens me to report this—but I think our listeners will nod their heads in agreement: there are a lot of very frustrated dentists in the United States who have awesome clinical skills. They’ve been to Pankey, they’ve been to Dawson, they’ve been to Kois, they’ve been to Spear. They’ve taken a massive amount of continuing education to build their skills.

And yet, they’re not able to use those skills often enough in their practice. Because if they’re presenting that worn dentition case to a patient who didn’t express interest in it, but now it’s come up through the exam that they have issues with worn teeth, and the first question out of their mouth is, “Does my insurance cover it?”—what is that indicating, Naren?

Naren Arulrajah: Like, they’re not thinking—it’s kind of going back to the book Pre-Suasion. You know, I remember that story Dr. Cialdini shared: if you want to sell a mattress and your mattress is all about comfort, have pictures of clouds on the ceiling and everything else, right? Same way, these patients have been pre-suaded to think, “Is it covered or not covered?”

Gary Takacs: It’s kind of like, you know, you’re trying to upgrade their mindset—you’re trying to sell them a Mercedes. Not my brand of choice, but we’ll use that as an example, as a lot of listeners would identify that that’s a high-end automobile. You’re trying to sell them a Mercedes, but the only thing they’re interested in is a Hyundai.

Naren Arulrajah: Yeah, exactly.

Gary Takacs: And that gap is huge. That gap is huge.

Naren Arulrajah: Yeah.

Gary Takacs: So I believe if you—

Naren Arulrajah: And that’s why they see you as a salesperson, because they’re thinking, “You’re just a sales guy wanting to sell me the, you know, Mercedes.”

Gary Takacs: Trying to buy your next Mercedes.

Naren Arulrajah: Exactly.

Gary Takacs: But, you know, and I think really, how to move patients from basic treatment to comprehensive care begins with how you bring patients into your practice. If you bring them in by signing up for every dental plan, you’re likely to live a quiet life of frustration.

Yeah, you have all these great skills, but the only thing they’re interested in is their free dentistry.

Naren Arulrajah: Exactly.

Gary Takacs: So that—that’s a little bit outside of the mechanical part about how do we move people along—but I want to recognize it. Because if you’re living that life of quiet frustration, reevaluate how you get patients.

What if—what if—you switched your marketing, in the form of organic SEO, in the form of your website design, in the form of your landing pages, to attract people interested in the kind of services that you have the capability of providing?

And then I’ll flip it to you, Naren. So I’ll take this next question. What would you recommend they do if all of a sudden the light bulb’s going off and saying, “Oh my gosh, this is making a lot of sense. All of my patients—the majority of my patients—come because I accept their insurance”? What should I do to start to shift that?

Naren Arulrajah: Yeah, that’s a great question, Gary. I think, um, you know, 2026—I’ve been doing this for 19 years—and I have noticed people no longer buy, like, the lowest-cost coffee or the lowest-cost anything. They want the high-quality product.

So the number one thing that people look at before they come to you—whether you like it or not—is your Google reviews. In other words, they’re using Google to figure out: A) can you help them with the problem they have? Assuming you can—for example, the gum disease example that I gave—and you have an article about gum disease and dementia, my light bulbs go off.

And I find that because Google is directly showing your website as a possible person I should contact, now I call your office. And your office does a good job. And I come in, I’m much more likely to stay there—as long as you continue that conversation. As long as you continue to talk about, “Hey, we do treat patients. We’ve had, you know, dozens and dozens of people just like you who have had a similar family history. And, you know, we have put them on a special, you know, gum treatment program. And this is what it looks like.” And they do my own—you know—they look at my own gums and so forth.

Now, I do think SEO is where everything starts—at least in 2026—for those patients who are looking for big cases or complex cases or who have special needs. They’ll start Googling those things.

Now I Google: gum disease dementia dentist near me. Boom. Three people show up. I pick the best one. I went—you know—called them up and I went there, right?

So that’s the sequence they’re going to use. Or, you know, they want a beautiful smile. And they notice this one colleague of theirs who used to have crooked teeth now has a beautiful smile. And they’re like, “What did you do?” And she’s like, “I wore Invisalign.”

They Google Invisalign. They start looking it up. They find three different people who can help them with Invisalign, pick the one who they think is the best, and they go to that person, right?

Gary Takacs: If we stay on theme with complex treatment—comprehensive restorative dentistry—one of the things you could do, listeners, is cultivate Google reviews. Five-star Google reviews from your patients who have experienced your comprehensive care.

Imagine—because today, I find it very unique, it’s a very, very unique human condition—people put value in Google reviews. They have no idea who wrote them. They have no idea what the credibility of the author of that review is. However, they put stock and they put value in it, right?

So imagine that you’ve had some good cases where the patient says to you after treatment, “Doctor, I am so happy I did this.” And a lot of times, their facial expressions show it when they look in the mirror for the first time with this beautiful restorative dentistry…

Gary Takacs: And very often you’re greeted with tears of joy flowing down their cheeks—they’re so happy. And if you were to say at that point—let’s say her name’s Linda—“You know, Linda, you just made my day. This is why I am so excited about being a dentist, helping you experience what you’ve just experienced. I have a request—when you get a chance, if you’d be kind enough to write us a Google review, maybe expressing everything you just said to me, that might help more people realize that comprehensive care is something that’s within their grasp. Would you be kind enough to do that for me?”

Naren Arulrajah: And by the way, here is a QR code.

Gary Takacs: Yeah.

Naren Arulrajah: And here is a QR code. You can do it right now if you have a couple of minutes.

Gary Takacs: I disagree there—I don’t like to do it right there. I think it’s pushing. I like to say, “Here’s a card. Later today, when you get a chance—we made it really easy for you—all you have to do is grab your phone and point it at the QR code. Later today, when you get a chance, if you’d be kind enough to write a review, I’d sure appreciate that.”

Now imagine that—now, when they’re looking for comprehensive care, and they see reviews that are talking specifically—not just “great office, great people, love them”—but they’re talking specifically about the kind of treatment. It could be Invisalign. It could be gum therapy. It could be a lot of other treatment that you are now being very strategic in how you’re cultivating those reviews.

And absolutely those reviews can result in people kind of connecting the dots—they now realize they have a problem. They probably Googled it. They’re now realizing they have a problem that deserves a solution. And now you’re coming up as the obvious solution.

Naren Arulrajah: Absolutely. I just was looking up a case study. A client who joined us around 16 months ago—they’re showing up 30,000 times for more than 150 keywords and phrases on Google Maps, on Google Search, and now on Google AI Overview and AI Mode.

Which means, like, 30,000 times when people are looking for things like Invisalign or veneers or whatever is important to them, this practice keeps showing up. Of course, they also have good reviews, which is something they worked on—every month they get 10 or more reviews.

And if anyone wants to get traffic through SEO without having to pay tons of money for ads—or, you know, even more for the PPO plans which take a cut of every dollar you make—go to ekwa.com/td.  That’s the meeting that Gary had eight or nine years ago on behalf of LifeSmiles.

So it’s a good way for you to find out how you’re doing with Google, how you’re doing with internet marketing, and, you know, get kind of a report card and a game plan. 

Gary Takacs: You know what’s interesting, Naren, is—it’s likely that patients that have dental insurance will ask you the question… let’s say they have these really worn teeth, and you’re presenting some treatment options to them. It’s likely they’ll ask, “Is that covered by my insurance?”

So, try to be mindful of how you respond to that question. Yes, it’s a fair question. It’s a fair question. It tends to spark sort of negative facial expressions and negative tone when we hear it.

But a way you can respond to that is something like this:

“Naren, if you were the patient, you asked, ‘Is that covered by my insurance?’” “Well, Naren, unfortunately, dental insurance was only meant to cover the most basic things—things like fillings and cleanings. What we’re talking about here is far from basic. So unfortunately, very little of that is going to be covered by your insurance.”

What’s interesting about that is—they’re not surprised. They’re really not surprised. They’re not happy with that response—they’d love it if we said, “Oh yeah, that’s free.” But that’s not the case.

But if you just respond to them nonjudgmentally, and in a favorable tone—“Unfortunately, dental insurance was only meant to cover the most basic things. This is far from basic.”

Naren Arulrajah: Yeah. Another way I’ve heard you explain it is, you know, “Dental insurance unfortunately doesn’t care about your smile, your long-term health. It’s all about fixing problems.”

Gary Takacs: I love to tell them, “Your dental insurance company hopes you never go to the dentist.”

Naren Arulrajah: Exactly.

Gary Takacs: Because if you never go to the dentist, they’ll never have to pay a claim.

Naren Arulrajah: Exactly.

Gary Takacs: And that lands on people today—because of the distrust that the public has with insurance companies.

Naren Arulrajah: I mean, even forget about dental—for critical illnesses, people are covered. And that’s in the media. People know this. Right? Dental insurance doesn’t want to pay—it’s almost like you’re fighting them to do the right thing.

Gary Takacs: You know? And how many hurricanes have hit the hurricane zone in the United States—and people thinking they were covered discovered they’re not covered?

Naren Arulrajah: There’s some fine print somewhere that says, “Oops, not this type.”

Gary Takacs: No-name storms, named storms—it doesn’t cover any named storms. Or, you know, you’re in California and the wildfires hit—and it’s like, “Oh. Nope. Don’t cover.” And the public recognizes that.

So now, let’s assume the patient has some interest. Right? How do you move them along?

Naren Arulrajah: I have a question for you, Gary. You talk about the concept called a value ladder. How does it apply here?

Gary Takacs: Well, um, I like to use value-add statements when we talk to patients—meaning, what’s in it for them?

So when we’re following up with treatment recommendations, it’s not just, “Hey, I see the doctor’s recommended some fillings. I wanted to give you a call and see if we can get those scheduled.” There’s no value. We haven’t communicated any value.

So I like to use value language. For the fillings example, we might say: “Fillings don’t get better on their own—they only advance to more decay that could lead to more complex treatment, like root canals and crowns. To avoid that, it might be better to get those taken care of now before they become something more complicated.”

That’s value-add, right? Now you’ve let them know why that would be important.

But when you have that patient that has comprehensive needs, there’s a good way to approach that.

And the good way to approach it is to speak to the obvious. Let me use an example.

So Naren, you’re that patient—late 50s, early 60s, severely worn teeth—but they don’t hurt. That’s where we are right now. And let’s say we’ve got some rapport. Maybe not a relationship, but we’ve got some.

Let’s assume this is the first visit. Naren, I’m roleplaying as if I’m the doctor, and you’re the patient.

“Naren, I’ve enjoyed getting to meet you today in your first visit to our office. Welcome to our patient family. I know it sounds kind of corny, but we think of our patients as patient family because we take care of you like we take care of loved ones. And I’m honored that you chose our office, Naren.

I’ve had a chance to gather some records today, and I’ve had a chance to take a look at some photos and also listen to you—about your past, what’s important to you…”

Gary Takacs: “But before I present a treatment plan, is it okay if I ask you a question?”

(And our listeners aren’t seeing this on video, but Naren and I are looking at each other on a Zoom call, and I’m nodding my head up and down.)

So I ask, “Is it okay if I ask you a question?”—I’m nodding my head. What’s the patient going to do? They’re going to nod their head. Yes. Yes.

Now, this is the way I would present it if we’re in rapport (not necessarily relationship, but rapport):

“Naren, it’s apparent to me that you’ve got a lot of issues in your mouth. And it may be apparent to you—for example, the teeth are a lot shorter than they should be at this stage in your life. But before I present a treatment plan, I want to ask you: Is now the right time to address what’s going on in your mouth—ideally?”

And then I zip it up. And just listen.

Now let me pivot and show you the difference between rapport and relationship.

Rapport is what I think of as the beginning of a relationship—the very beginning. It could be they don’t trust you yet, but they kind of like you. It’s very embryonic. It’s developing. It’s unfolding, and perhaps has the opportunity to become a relationship.

Let’s say that I know something about you, Naren, that’s come up through our new patient coordinator who spent time with you at the beginning of the new patient appointment. And we’ve discovered that you’re new to the area, you’re a young grandfather, and you’ve relocated to the area—that’s why you’re seeking out a new dentist. You’ve relocated to be closer to your kids and grandkids. And now I know that.

So when I ask you, “Is it okay if I ask you a question before I present the treatment plan?”—and you say yes—I say:

“You know, I’ve learned that you’ve relocated here recently—you and your wife—to be closer to your kids and grandkids. Naren, what an exciting time of life, and what a great decision you made to be closer to your family.

Now, it’s been a while since I’ve moved, Naren, but I remember the last time I moved there were a lot of moving pieces going on—a lot of boxes to unpack, a lot of things going on with respect to your recent move and getting settled in a new community. Is now the right time to address what’s going on in your mouth—ideally?”

Now that’s a whole different level of discussion. Because I know more about you. It’s not so cold—it’s more related to you.

It might be, “You’ve got kids in college.” “With respect to the fact that you’ve got kids in college and you’re facing tuition bills—is now the right time to address what’s going on in your mouth, ideally?”

Let’s go back to the first example. The grandfather might say:

“You know, it really is a good time. I want to look and feel my best. It is a good time. Let me know what we’re looking at.”

The parent who has kids in college might say:

“Oh yeah, we funded their college years ago—we’re in good shape. Yeah, now’s a good time.”

Or they might say:

“No. As a matter of fact, I’m tuition-poor right now.”

And if they say no, your fallback at that point can be:

“I totally understand, Naren. I remember when we had three kids in college at one time”—true story.

“What I’d like to do, Naren, is get your commitment to regularly scheduled hygiene appointments in our practice.”

Let’s say you have healthy gums:

“Naren, it looks to me like you have healthy gums, which means we’d like to see you every six months. That’s the frequency we’d like to see you.

During those hygiene appointments, I’ll come in and do an exam and give you a progress report on what’s going on in your mouth. If things are holding, I’ll let you know they’re holding—meaning they’re holding okay.”

Gary Takacs: They’re not digressing. However, if things start to advance clinically, I’ll also let you know that, so you can have all the information you need to make good decisions.

Naren, how does that sound to you?

Naren Arulrajah: Sounds great.

Gary Takacs: So everyone says the same thing—“That sounds great.” But notice what I’m doing—I’m keeping them in the relationship of the practice. That way, every time we see them—every six months—we’ll get a check-in.

And it might be: “Hey, Naren, good news. It looks like the teeth are stabilizing. They’re still severely worn, but they’re stabilizing. I don’t see things progressing to the point where it becomes more urgent.”

Or it might be: “I’m concerned. Teeth are starting to shift. I think we should take care of this before it becomes something more complicated.”

Because the truth is, one of the ways to do more complex care—do more ideal care—is to see people on a regular basis. To see those patients over time.

Because I have a data point, Naren, from our coaching.

High-value dentistry—among our coaching clients—high-value dentistry like implants, cosmetic dentistry, adult orthodontics, complex restorative dentistry, treating obstructive sleep apnea, doing oral conscious sedation… 60% of those high-value cases come from existing patients who are now coming through hygiene on a regular basis. And now—they’re ready to do it.

Now they’re ready to do it.

40% comes from new patients that are seeking you out—trying to find a dentist to help them with a problem they’re aware of.

And I don’t think that’s unique to our client base. I think that would be very accurate among any of our listeners.

Naren Arulrajah: I think the ones who are doing SEO—that number even goes up, because people are seeking out these complex cases. But unfortunately, the traditional dentist doesn’t have that relationship, nor that rapport with the patient you’re describing.

It’s almost like “fix-it dentistry.” I go there, and, you know, I’m on a PPO plan.

Gary Takacs: No, it’s like a Jiffy Lube oil change.

Gary Takacs: As opposed to a garage that does complex—

Naren Arulrajah: As opposed to a Mercedes-Benz, uh, you know, like repair shop. They’ll send a car to pick you up. And I know they’ll charge you an arm and a leg, but they’ll give you a VIP treatment. And people who want quality will pay for it.

Gary Takacs: Which speaks to, you know, another point as we add layers of complexity here—does your office look like a place that someone would spend X amount of dollars for complex restorative care? Does it look like it?

And by the way, I’m not talking about opulence here. I’m not talking about chandeliers and, you know, very fancy finishes. I’m just talking—does it look like a place… Does your team communicate in such a way that’s consistent with the quality of dentistry you deliver?

Do they answer the phone right?

You know, Naren, I do a lot of telephone training. And this happened last week—it’s very fresh on my mind.

Caller said, “First of all, are you accepting new patients?” And the team member that answered the phone said, “Yes.” Just “yes.” Then they asked, “Do you guys do dental implants?” And the team member said, “Yeah.” And that was it.

Naren Arulrajah: No credentialing, no nothing, right?

Gary Takacs: No. No further response. That was it.

What kind of sentiment do you think the caller—who’s curious about implants—is feeling at that point?

Naren Arulrajah: They don’t really care about implants. Or they’re not really good at implants. That’s why. Like, okay, I’m not buying a packet of milk, you know. I’m buying something that is my life savings—or my next car. Like, I know I’m—

Gary Takacs: Making a big decision here.

Naren Arulrajah: Yeah, exactly.

Gary Takacs: And it could have been easily adjusted by saying:

“You know, our doctors love doing all kinds of dentistry. They have lots of advanced training. They especially love helping our patients restore their dental health with dental implants. You called the right office.”

Now, I didn’t time myself on that—but I believe that was about 12 seconds, Naren.

Naren Arulrajah: Exactly.

Gary Takacs: How about that? A 12-second response… instead of, “Yeah.”

Naren Arulrajah: Right.

Gary Takacs: It’s different. So all this contributes. All this contributes.

And then, you know, another idea is—think about how your office is decorated. Now, that’s a matter of individual taste, of course.

But in the back part of your office—in the clinical area—I would suggest the only artwork you have up are beautiful after-photos of patients you’ve helped with the high-value dentistry that you do.

Beautiful after-photos.

Not before-and-after on the wall. Before-and-after is scary on the wall. You can show before-and-afters in a digital photo album.

But on the wall, I’d like beautiful after-photos.

And that way, when we’re bringing a new patient into your practice, your new patient coordinator could stop at one of those photos and say something like:

“You know, our doctors love doing all kinds of dentistry. But they especially love helping our patients with things like Invisalign, dental implants, complex restorative dentistry, cosmetic dentistry. All of the photos you see back here in our office are actual patients of ours who we’ve helped have the smile of their dreams.”

Naren Arulrajah: Right.

Gary Takacs: So either I’m planting seeds at that point, or I’m confirming that this is something that you guys do.

Naren Arulrajah: Yeah.

Gary Takacs: And all of that is about answering that question: How do you move people from basic treatment to comprehensive dentistry? How do you move people along?

Naren Arulrajah: Absolutely. Gary, let me—I have two questions. I know we have to wrap it up soon, so perhaps we can keep these answers a little short if possible.

What role does hygiene play in this entire process?

Gary Takacs: Hygiene’s absolutely critical. And, you know, it’s interesting—there are some doctors, some dentists today thinking that it doesn’t even make sense to have hygiene anymore. “If I’m a PPO practice where I’m losing money every time I do hygiene, with the rising hygiene wages…”

And my answer is as strong as it’s always been: I believe that a thriving practice has a very strong hygiene department. Absolutely.

The role of the hygienists is to ask the right questions to your patients—to spark some interest, to identify areas of concern—without diagnosing. Your hygienists aren’t diagnosing, but they can say:

“George, it looks like we might be experiencing some more wear here on the back. I’m going to ask the doctor to take a look at those teeth today when he comes in. I’m concerned.”

And those two words, Naren—

Naren Arulrajah: “I’m concerned”—are key.

Gary Takacs: Yes. “I’m concerned.” Because if your hygienist is concerned, likely the patient is beginning to think, “Maybe I should be concerned.”

Naren Arulrajah: I think you’re also tapping into something fundamental in human nature. Right?

The hygienist spends a lot of time with the patient. Like, I know my hygienist—you know, I know her kids, I know how old they are. Every time I go, I ask, “What are they up to?” “Oh, they’re in summer camp,” or “They’re back in school,” and she asks about my kid.

Because I’m sitting there for 45 minutes while she works on me. And somehow I get to talk for a few minutes.

So when she recommends something—I listen. Because I like her. I feel like—

Gary Takacs: There’s also the perception that your hygienist is more like you, as a patient.

Naren Arulrajah: And she cares about me, because she’s the one who’s working on me, right? Like, every so many months.

Gary Takacs: Yeah. She’s more like you.

Naren Arulrajah: Yeah, exactly.

Gary Takacs: And it’s a softer… And again, she doesn’t have to diagnose. She can just say:

“I’m concerned about something I see here.”

When it comes to Invisalign or aligners, our hygienists can simply be looking for crowding or spaces and ask the question:

“Naren, if there was a way to correct the crowding in your teeth without brackets or braces, would you have any interest?”

If the patient says, “No, I’m perfectly fine with my crowded teeth,” then that’s fine.

But more often than not, they’ll say:

“Yes, I had braces as a young adult. I don’t want to look like I’m in middle school again. But if it could be done without brackets or braces, I am interested.”

Then she can do a pass-off when the doctor comes in:

“Doctor, Naren is interested in learning if he’d be an appropriate patient for Invisalign to correct the crowding in his teeth.”

So—they’re partners. Think of your hygienist as partners in case acceptance. Partners.  And it’s critical.

Your hygienists have to know what you do. They have to develop the verbal skills and the confidence to talk to patients about this—to ask the right questions.

It could be an open-ended question: “Do you have any concerns, Naren, that you’d like to bring up to me?”

And if the patient says, “Yeah, something like this,” say: “Do I have your permission to share that with the doctor when he comes in to do the exam today?” “Yes, please.”

And then—it’s almost like they’re bridging the gap between you and your patient.

But very, very, very important.

Naren, as we come to the finish line on this podcast episode—How to Move Patients from Basic Treatment to Comprehensive Dentistry—I want to close on a really positive note.

You absolutely can move patients—with a mindset of basic treatment—you can move those patients along to comprehensive dentistry.

Not all, perhaps. Maybe not everyone.

But you can.

And I would begin by thinking very seriously about how you market your practice.

Is your practice an office that comes up when people are seeking comprehensive dentistry?

And if it’s not, then I’d schedule a marketing strategy meeting right now with Ekwa— Because that’ll change very quickly.

Gary Takacs: Link is—

Naren Arulrajah: ekwa.com/td,  in case somebody wants to write it down. I’ll put a link in the show notes as well.

Gary Takacs: Yep. ekwa.com/td.  Be sure not to miss it—com slash TD.

Naren Arulrajah: Yes, slash TD—Thriving Dentist.

Gary Takacs: Yes, yes.

On that note, it’s still early in the year. Naren and I want to wish you a very Happy New Year.

Here’s to making 2026 your best year yet.

Naren and I look forward to connecting with you on the next Thriving Dentist Show.