Expense and Time — The 4 Pillars that Elevate Every Dental Consultation (F.A.T.E. Approach)
- Filo Insstitute
- Nov 17, 2025
- 12 min read
Following the first article - Fear and Expectation — The 4 Pillars that Elevate Every Dental Consultation (F.A.T.E. Approach), the second part will explore how Affordability and Time constraints influence patients’ acceptance of dental treatment plans. It emphasizes the importance of clear, empathetic communication—using the 7-38-55% rule (words, tone, body language) to build trust and present treatment costs without pressure. Techniques like the “Rule of 3” ensure genuine patient commitment. Early discussion of budgets and realistic scheduling helps prevent last-minute cancellations and financial losses. The article highlights common patient scenarios where hidden barriers, especially time management, offers strategies to address them with patience and clarity for better outcomes.
Affordability
One of my patients from Germany gave me an excellent reply when I turned the conversation quite hesitant towards finance.
“I saw your prices, I checked outside in the waiting room, that’s why I am here - I want to get treatment done.”
This might be a rare case as patients tend not to check the website before they attend to the initial consultation. If it is possible, ask the person who is contacting your patient to give them an estimated price which will make the consultation easier for you. As there will not be a sock for them what to expect and the patients could decide even if they are willing to pay for your time.
What is the patient’s budget?
The main point during treatment plan consultation is to understand what is the patient’s budget, in other words how much their teeth are worth for them. Many patients are more worried about their car or their nails & hair than their teeth, so might be a good starting point to compare those points to their dentition.
The 7-38-55 percent rule
Before you introduce the cost, you need to build value and trust. Once all the clinical aspects - including options and pros & cons (value) have been discussed and you are aware of the patient’s main needs (trust), then it is time to move to the financial side.
“Before we move forward, I want to make sure we’re both on the same page—not just clinically, but financially too. Using the 7-38-55 percent rule by Chris Voss [1]:
7 % (percent) - the words you explain to the patient,
38 % (percent) - the tone of the voice used during the consultation,
55 % (percent) - the person’s non verbal communication style.
Patients often don’t remember your exact words, but they always remember how you made them feel. This rule reminds you that how you say something carries far more influence than what you say, especially during sensitive moments like discussing cost.
7% – The Words (What You Say)
The words you choose must be deliberate and neutral—especially when discussing sensitive topics like treatment options and cost. Rather than abruptly introducing "money" or pushing a particular solution, your phrasing should focus on collaboration and clarity.
When introducing the cost - Instead of saying, “Here’s what it costs,” you’re saying, “Let’s make sure we’re aligned on both the clinical and financial sides.” → This kind of language fosters openness, trust, and shared responsibility.
Importantly, it’s critical not to present one treatment as “better” or pressure the patient toward a particular choice. As professionals, we must avoid bias and resist the urge to decide for the patient. Instead, stay neutral and present the facts, allowing the patient to make an informed decision—just like any responsible adult making a health-related choice.
For example, you might say:
“If your goal is to save the tooth, a root canal treatment followed by cusp coverage would be required, and the cost is XYZ. However, if you decide not to keep the tooth and accept the long-term consequences of its loss, extraction and replacement would cost XYZ.”
38% – Tone of Voice (How You Say It)
Your tone of voice carries immense weight—more than many realize. It’s not just about the words you speak, but how you say them. A warm, steady, and confident tone communicates professionalism, calm, and control.
On the other hand, a tone that’s overly enthusiastic can come across as salesy or insincere, while a hesitant or apologetic tone may signal uncertainty or lack of confidence. Both can unintentionally erode trust—even if your clinical skills are excellent.
💡 For Early-Career Dentists:
If you're early in your career and still developing your consultation style, practice is key. Try rehearsing in front of a mirror to observe your facial expressions and body language. Or role-play scenarios with your nurse to simulate real-life patient conversations. The more familiar and prepared you feel, the more natural your tone will become.
Remember, patients are perceptive. They can sense whether you believe in what you're saying. Most patients already understand that dentistry is an investment.
55% – Body Language (What You Show)
Here’s where the biggest impact lies:
Make eye contact when you say the number.
Sit upright, with open posture, and no crossed arms.
Avoid fidgeting or looking at your notes while talking about money.
Smile subtly and nod slowly to show confidence and reassurance.
After you say the number, wait until the patient replies first. Why?
Negotiation is similar to a ball game where the match started by introducing the number. Next step, wait for the reaction of the patient and lead the game which is controlled by the “listener” as mentioned above. Reactions for prices are various, the most common one is the shock when they realise how much it will cost their desired dental care.
In order to move on from the awkward moment you could ask:
“It seemed like there was a hesitation in your voice”
“It sound that you were surprised of the cost of the discussed treatment”
Scenario 1: Building Value Before Introducing Cost
Setting: A calm, private consultation room. The dentist has just finished discussing two treatment options for a molar with extensive decay—saving the tooth with a root canal and crown, or extracting it and placing an implant.
Dentist (smiling warmly, steady tone, sitting at eye level with the patient): “Okay, Sarah, we’ve now gone through both options clinically, and I appreciate how engaged you’ve been in understanding everything. Before we move forward, I just want to make sure we’re both on the same page—not just clinically, but financially too.”
(Makes eye contact and pauses briefly to gauge her reaction)
Dentist (calm tone, open body language): “I’m not here to tell you what’s best—this is your health, and ultimately, your decision. My job is simply to give you all the facts so you can make a choice that feels right for you.”
(Subtle nod, relaxed shoulders)
Dentist: “So, if your priority is to save the tooth, that would involve a root canal and a crown to protect it. The total cost would be around €XYZ. Alternatively, if you feel the tooth isn’t worth saving and you’re okay with the long-term implications of losing it, we’d look at removing it and placing a dental implant. That full process would come to about €XYZ.”
(Looks Sarah in the eyes when saying the numbers. Then the dentist should stay silent while looking Sarah’s eye and WAIT)
Sarah (Pauses, her eyes widen slightly)
"Oh… okay. That’s more than I expected."
Dentist (gently): "It sounded like you were surprised by the cost of the treatment?"
This approach combines:
Value → All options clearly explained with pros and cons.
Trust → The patient is treated as an adult capable of making their own health decisions.
7-38-55 Rule
The patient then will start explaining their concerns, they might try to bargain or give the “let me think about it” answer.
If you have the time or love challenges you could go and start the “game and bargain with them” or let the Treatment Coordinator (TCO) handle them. However, there is another way to identify if the patient is really interested in the treatment and will book the next appointment, called the “Rule of 3” (Never Splint the Difference - Negotiating as if your life is on it by Chris Voss) [1].
The rule of 3 in negotiation
There are many situations in life when you get a “Yes” that later turns out to be a “No”. Especially, in the dento -medical field as many patients do not want to confront the doctor or they might be too anxious to reveal their need. “Rule of 3” is a negotiation technique when the patient agrees to the same thing 3 times (3 YES) in the same conversation as it’s challenging to fake conviction or lie repeatedly.
Commitment Yes
Conclusion Yes
Calibrated Yes
Let’s discuss this in more detail. The first time when the patient agreed is the commitment “Yes”. After the comprehensive consultation, the patient seemed determined and ready to go. Second time on the same consultation time - you summarize which you agreed
“Let me conclude which we discussed and agreed on” and make sure the number (price) will be mentioned again. The result of the summarisation that you could expect from your patient’s response “Yes” or “that is right!”
If they still seem worried, use a calibrated question (see previous article -Fear and Expectation — The 4 Pillars that Elevate Every Dental Consultation (F.A.T.E. Approach)).
“What is the biggest challenge here?”
“What do you see as being the most difficult part to get your treatment done”.
They will reveal their true burden and you get the “ball” back and lead the conversation. This is the time you could introduce payment options or strategically involve your front desk or TCO as an additional support form them. If the nervous patients leave the surgery they might think clearly and able to make a decision especially if they have also anxiety of dentistry.
Scenario 2: Patient Hesitates Due to Time and Unspoken Anxiety
Context: A female patient, 29, is told she needs multiple fillings and a crown. She initially agrees during the consultation but looks overwhelmed (Commitment Yes).
Dentist: "Emma, just to wrap up: you need four small fillings and one crown. We talked about doing it in two visits over the next three weeks. The cost will be € XYZ total (Silence - wait) - (Conclusion Yes).
Patient (fidgeting): "Um... I mean, yeah... I just don’t know if I can get time off work."
Dentist (calibrated question* ): "It sounds like fitting the appointments around your schedule is going to be tricky. How often do you think you’d realistically be able to attend?"
Patient: "I don’t know… My work is really full lately. And honestly... I just get anxious even thinking about the needle."
Dentist (acknowledging fear + time): "I'm really glad you brought that up. It seems like the combination of fear and time constraints is adding to your stress. What would help you feel more confident about moving forward?
Patient: "If I could just get a shorter first appointment… just ease into it." (Calibrated Yes)
Dentist: "Absolutely. Let’s start with just one small filling—30 minutes only. If that feels okay, we can go from there. I’ll have our receptionist book just that for now and hold off on the rest until you decide."
Scenario 4: Patient Agrees, Then Doubts Due to Financial Pressure
Context: A male patient, 61, needs a lower partial immediate denture. After the exam, he nods and agrees. But when the treatment plan is presented, he becomes quiet (Commitment Yes).
Dentist: "Martin, just to summarise: We’ll take an intraoral scan this week, do a fitting in two weeks, and you’ll have your immediate denture by the end of the month. It’s €XYZ, and you mentioned earlier this is something you’ve been meaning to fix (Silence wait again) (Conclusion Yes).
Patient (mutters): "Yeah… I suppose. I mean, I guess I don’t have a choice."
Dentist (noticing lack of conviction): "It sounds like you’re not completely sure. What’s the hardest part about going ahead with this right now?"
Patient: "To be honest… it's the money. I’ve got car repairs and some other stuff coming up. I didn’t expect it to be this much."
Dentist (non-judgmental, supportive): "I understand. A lot of people feel the same when it all comes at once. Would it help if we looked at options to split the payments or perhaps break the treatment into phases?"
Patient (visibly relieved): "Yeah… splitting it up might make it easier to manage."(Calibrated Yes)
Dentist: "Let’s do that. I’ll walk you through two options with our front desk manager—no pressure. And I’ll also email / print out everything we discussed so you can look it over.
We’ll hold your spot for 3 days so you’ve got time to think."
As one insightful patient once told me, “I saw your prices, I checked outside in the waiting room—that’s why I’m here.” While not every patient is this upfront or informed, setting clear expectations about cost, early on, can reduce surprises and build trust. During consultations, focus first on clinical value and emotional connection before discussing money. Apply the 7-38-55 Rule to enhance communication: 7% words, 38% tone, and 55% body language. Once aligned clinically and financially, test true patient commitment using The Rule of 3—securing three consistent “yes” responses to ensure genuine agreement.
Time
Seneca, the Roman Stoic, wrote, “It is not that we have a short time to live, but that we waste a lot of it” this idea resonates deeply in dentistry, where time, both the dentist’s and the patient’s, is one of the most underestimated resources. During consultations, many patients appear hesitant without revealing their real concern: Do they truly have the time to follow through? It’s essential to explore this early, rather than face last-minute cancellations or unkept appointments later on.
Time: The Overlooked Barrier in Dentistry
In many cases, patients assume the dentist is always available on their terms, or they may overcommit without fully understanding the time needed for their treatment plan. That's why it's important to introduce the idea of mutual time investment during the first consultation. Let patients know that their time matters and so does yours. Respect is mutual, and so is commitment. Explaining your cancellation policy early and clarifying appointment lengths helps patients value the structure and effort behind their care.
In order to understand a patient's interest and commitment, it might be useful if during the first consultation you introduce some “general questions”. These are strategically organised “small talk” questions which provides insights into their schedule and travel effort, and help to break the ice at the beginning:
Do you live nearby?
Did someone accompany you here?
Did you come from work or do you finish for today?
As discussed above and in the previous article, it’s not just fear, financial concerns, or expectations that impact treatment acceptance: time can be a major hidden barrier. The earlier you recognize when a patient is unlikely to prioritize their dental care, whether due to busy schedules, long travel distances, or unpredictable family commitments, the better you can prevent costly last-minute cancellations or no-shows. These disruptions not only affect your planning but can also lead to significant financial loss for your practice.
Let’s look at the 5 most common scenarios where time becomes a silent obstacle to treatment acceptance.
Scenario A: The Always-in-a-Rush Professional
Patient: “I travel a lot for work… I’ll call when I know my schedule.”
Dentist: “It sounds like your work keeps you very busy. How often would you realistically be able to come in for appointments?”
🧠 Hidden Reason: The patient doesn’t think they can fit regular appointments into their routine but doesn’t want to admit that up front.
Scenario B: The Accompanied Decision-Maker
Patient: “I’d prefer to wait until my wife can come with me to decide.”
Dentist: “It seems like your wife’s opinion is really important in making treatment decisions. Would it help to schedule a consultation where he can join us too?”
🧠 Hidden Reason: The patient is unsure about committing without their partner's input and fears having to rearrange multiple appointments.
Scenario 3: The Overwhelmed Parent
Patient:“I really want to fix my teeth, but I have the kids all day… it’s just been non-stop lately.”
Dentist (calm tone, gentle posture): “It sounds like your family keeps you on your toes right now.” Follow-up calibrated question: “How could we work around your schedule in a way that doesn’t add more stress?”
🧠 Hidden Time Concern: Patient may not have child care or feels guilty spending time on herself.
Lead the Conversation Around Time and Commitment
Once you've established a basic understanding, move gently into more direct scheduling talk:
“Let’s make sure we both have enough time to carry out the treatment. How often could you realistically attend appointments?”
Framing the question this way empowers the patient while reinforcing that time investment goes both ways. If a patient seems hesitant to commit, don’t rush into scheduling a long appointment. Instead, start with small steps by addressing their immediate concern and use each visit as a trust-building step, like stacking Lego blocks.
Offer a clear timeline for each option and give them no more than a week to decide. If they continue hesitating, move forward with other patients. Ironically, when patients realize they might lose the opportunity, they often become more committed. In dentistry, if you snooze, your smile might lose!
Scenario 5
Patient (hesitant): "I understand the treatment plan, but I just need more time to think it through."
Dentist (calm and supportive tone): "That makes perfect sense, this is a big decision, and I want you to feel confident about it."
(Leaning slightly forward, keeping eye contact) "To help you move forward, I’ll offer a clear timeline for each option. I will offer you a free review in a week. That way, you can see which options fit best with your schedule and comfort level."
Dentist (gently): If I don’t confirm you appointment, I’ll assume you’re not ready to begin and will reserve my schedule for other patients who are ready to move forward."
Patient (surprised): "Oh—I didn’t realize there was a time limit."
Dentist: "It’s not pressure—it’s about making sure I give everyone the attention they need. But if the time feels right for you, we’ll move ahead together and make sure you’re fully supported."
Summary
This article highlights how financial concerns and time constraints often affect patients’ decisions to accept dental treatment. It emphasizes building trust before discussing costs using clear communication and reading body language. Understanding patients’ budgets and schedules early helps prevent cancellations and financial losses. The article also offers strategies to confirm true commitment and handle common time-related obstacles.
Have you faced challenges with time or expenses during consultations? Share your experience!
References:
