Last month I complained that “garage math” inflated the final repair bill for my car, and concluded that financial surprises are inappropriate for both car owners and dental patients. But what financial expectations should we have for a patient, when we encounter unanticipated complications arising during treatment?

Early in my career, I referred a pediatric patient to a specialist as I was a bit uncomfortable regarding the child’s management.  The child, however, was great, the mother was pleased, and the restorative services were completed.  In a follow up conversation with the pedodontist, I learned that the proximal decay of one molar was deeper than it appeared radiographically, and a planned Class II amalgam turned into a pulpotomy and crown.  Regardless, the patient’s final invoice was unchanged from the original fee quotation.

When I asked my specialist friend why he didn’t charge the child’s parent for the additional services rendered, he said the failure to diagnose the possible need for the pulpotomy and crown was his, not the mother’s.  Shazzam!

That lesson, learned many years ago, has served me well!  While we cannot foresee everything, we can take appropriate steps to enhance success:

1. Use all diagnostic tools necessary to determine recommended treatment.
2. Educate each patient regarding their status of oral wellness or need.
3. Communicate treatment goals clearly with the patient.
4. Discuss any potential complications which could change treatment or fees.
5. Listen well before rendering care to assure mutual understanding.

Regardless of our best efforts, small issues are bound to occur.  Which of us hasn’t broken the clasp off an old partial denture at the request of a patient to tighten it?  And which of us hasn’t had to replace a new crown following porcelain fracture due to our failure to properly balance the occlusion after insertion?

The proper, ethical, and professional care for our patients, will occasionally require that we take the financial responsibility to “make things right,” but following the suggested guidelines above can help us avoid unpleasant post treatment surprises and potential financial catastrophe!

*Special credit to JUMBLE illustrator, Jeff Knurek,  for the graphic used above


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“Honesty is always the best policy.”
Ben Franklin

Dr. Kerr

Author Dr. Kerr

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