Stop Wasting Leads Series: Retention, Not Just Acquisition, Drives Dental Growth.

Why mid-funnel metrics like reappointment and treatment
acceptance are the real drivers of sustainable dental growth.

In my last article, Stop Wasting Leads: How to Diagnose Top of Funnel and Reduce Leakage, we dug into why many dental practices struggle to convert marketing leads into scheduled patients—and what to do about it. From call center breakdowns to CRM systems and lead tracking, we mapped out how to stop the funnel from leaking.

Too many practices chase new patients while letting existing ones slip away. Here’s how to fix the back half of your funnel to improve ROI and fuel real growth.

But if you think the job is done when the patient books the appointment, think again.

Marketing ROI Doesn’t Stop at Scheduling

Let’s be honest—your marketing ROI doesn’t end when a patient schedules. That’s just the midpoint of the funnel. The real value is realized when the patient shows up, accepts treatment, reappoints, and becomes a long-term part of your practice.

Otherwise, you’re churning patients through an expensive hamster wheel—many of whom are just bouncing from one practice to another. It’s like Frogger: you dodge obstacles across the funnel, only to get flattened by poor retention halfway through.

The Unspoken Truth:

Most “new patients” you’re attracting were another practice’s recare or recall failure last month.

If you’re not reappointing and retaining your patients, you’re doing the heavy lifting to grow your competitor’s practice, not your own. The offices that grow the most predictably and profitably are the ones mastering mid-funnel retention and downstream patient value.

Let’s walk through how to close that gap.

Step 1: Start with Capacity – How Far Out Is Your First Hygiene Visit?

Before anything else, check your hygiene capacity.

If your next available hygiene appointment is more than 10 days out, you’re already in a danger zone. Today’s dental consumer is less loyal, more insurance-driven, and convenience-obsessed. They might accept your four-week-out slot—but they’ll also call the next provider and book if they can get in sooner. They won’t cancel. They just won’t show.

That’s how you end up with 20%+ no-show rates.

Quick fix:

Use AI tools and analytics to monitor capacity trends and flag high-risk days
Train your team to create short-call lists and leverage smart reminders for patients likely to no-show
Audit how long it takes for new patients to get their second hygiene visit scheduled—not just the first

Step 2: Measure Reappointment Rates—and Split by Provider Type

If you want to diagnose your mid-funnel health, there’s one metric to prioritize: Reappointment Rate.

But don’t just look at the average—break it down by provider type, because what you’ll often find is this:

Why the gap?

Hygiene is cyclical: 3, 4, or 6 months—patients expect to rebook
Doctor visits are often reactive. If treatment isn’t accepted and scheduled at that visit, it falls through the cracks
Many dentists doing their own hygiene forget to reappoint, as they’re focused on care, not logistics

Action items:

Run weekly reappointment reports by provider type
Add reappointment prompts into your PMS software for doctors doing hygiene
Deploy AI-enabled follow-up systems to identify and message patients who left without rebooking.

Step 3: Track Treatment Presentation vs. Acceptance

Another critical mid-funnel down metric: Treatment Acceptance Rate.

If dentists are presenting but not seeing acceptance, it’s not just a lost opportunity—it’s a clinical failure. The patient isn’t getting the care they need, and by default marketing ROI looks worse. A few things for clinical leadership to watch for:

Aggressive treatment plans that don’t align with patient readiness or budget
Weak financial conversations or lack of financing options for the patient
No clinical urgency during case presentation that could avoid major dental problems for the patient down the road

It’s easy for the offices to blame marketing for attracting the “wrong type” of patient. But if the patient scheduled and showed up—they’re qualified. We want the patient to get the care they need and at this stage the breakdown is usually in presentation or communication.

Fix it with:

Clinical mentoring and case acceptance coaching by clinical leadership
Offer flexible and multiple financing options to meet patients where they are

Step 4: Reappoint Before They Leave the Office

This is the most obvious—yet most missed—step.

Every day, patients walk out of dental offices with no next appointment. That’s lost appointments. Lost loyalty. And the beginning of a reactivation nightmare.

Whether it’s a hygiene recall or a crown follow-up, every patient should be scheduled before they hit the parking lot.

The usual culprits:

No reappointment handoff at the front desk
Using passive language versus assumptive language
“Let them call back when they check their schedule”
Dentists doing hygiene who forget to schedule
No systems or scripts in place

Your Fix:

Use scripting like: “Let’s go ahead and reserve your next visit before life gets busy.”
Set team goals around reappointment rate
If doctor is doing appointment, train him/her on how to schedule patient for next visit
Build visual cues in operatories and front desks that normalize scheduling on the spot

Step 5: Let Marketing Help Close the Reappointment Gap

Marketing’s role isn’t just bringing patients in—it’s helping you keep them coming back.

Smart marketing teams influence retention by shaping the patient experience, reinforcing education, and coordinating follow-up messaging.

Think of the office as a retail environment with a defined patient flow. Below are just a few examples—there’s much more to optimizing the full in-office experience.:

Lobby: This is not the place for silver filling photos on the walls or mouths wide open art work. Instead, use in-office TV solutions like TrueSync Media, which play 1-hour loops of engaging content (news, sports, weather), lifestyle messaging, and 10–15 minutes of content about your dental services. For example, use messaging that reinforces the importance of reappointment, such as:

- “Why Skipping Your 6-Month Visit Can Cost You Later”
- “Keep Your Smile Healthy—Your Next Visit Is Already Waiting”

Hallways: Display credentials/degrees, local community involvement photos and photos of your team giving back (e.g. booth at church festival). These build trust and rapport

Operatories: Use chairside visuals or operatory TVs to reinforce why follow-up care matters. Patients are more open to medical discussions here than at the front desk

Reinforce your message outside the office:

Automated texts and emails triggered by visit or treatment type
Personalized follow-up for patients who left without booking
Consistent messaging across in-office TVs, email, text, and social media

Example Patient Journey:

Sees a screen in the operatory: “Let’s keep your smile healthy—see you in 6 months!”
Receives a text: “Thanks for visiting us! You’re scheduled for your next cleaning in March.”
A month later gets your e-newsletter: “Why Skipping Your 6-Month Visit Can Cost You Later.”
Sees a matching social media post on your office’s Facebook or Instagram

That’s what consistency looks like—and it drives retention.

Four Fast Wins to Improve Retention and ROI

If you’re spending big on digital ads but not seeing long-term growth, your answer is likely behind the front desk, not in the ad copy.

Here’s where to start:

Understand your capacity constraints – get patients in within 10 days or no-show rates will escalate
Split your reappointment data by provider – Aim for 85%+ in hygiene across both insurance-based and fee-for-service offices (Medicaid-focused offices have a lower benchmark at 65%-70%). Investigate doctor follow-ups and fix those first
Make reappointment before the patient leaves a non-negotiable – Schedule everything: cleanings, crowns, consults—before they hit the door
Fix retention before you increase lead volume – leads won’t fix a leaky bucket. Marketing and ops need to work in sync across the funnel

Final Thought: New Patients Fill Schedules. Retained Patients Build Practices.

If your goal is same-store growth, it’s time to stop viewing marketing as just an acquisition engine. The best-performing group practices and DSOs understand that marketing ROI improves dramatically when clinical, operational, and marketing teams work together across the full patient journey.

Metrics like reappointment and treatment acceptance aren’t just clinical—they’re key marketing drivers. Retention is a shared responsibility—and the stronger it is, the less you need to spend on constantly chasing new patients.

Stay tuned for my next article.

If you have questions or need help diagnosing your funnel, email me at [email protected] or connect on LinkedIn

Ryan Torresan is considered one of the leading marketing minds in dental and healthcare on what’s next in marketing, relevance, marketing that actually impacts DSOs and can be measured. With more than 10 years of DSO experience, Ryan is a marketing executive who steered a very successful career to reach the executive level at three of the largest dental support organizations (DSOs) in the US.

During his tenures, he earned promotions and awards after tremendous success in the digital marketing and social media space. He is also known to have transformed event, CRM and content marketing into lead generation. He has repositioned brands, navigated crisis public relations and driven incremental sales through office designs. He played a crucial role on executive teams that sold DSOs to private equity firms.