How Teledentistry Can Help DSOs Fill Their Patient Schedules 

Written by Jamie Collins, RDH-EA, BS

Persistent Post-COVID Scheduling Challenges

In January 2022, the ADA’s Health Policy Institute conducted a tracking poll titled, Economic Outlook and Emerging Issues in Dentistry. Its purpose was to better understand the economic and operational conditions in private practices, DSOs, and public health clinics over time, and to measure the impact of the COVID-19 pandemic and other emerging issues in dentistry.

The tracking poll was updated in May and although we’ve made progress moving forward from COVID-19, there are still several challenges that continue to impact DSOs.

For example, when asked, ‘Which of the following factors prevented your dental practice appointment schedule from reaching 100% capacity last week?’ DSO-affiliated poll respondents gave the following responses:

  • Trouble filling vacant staff positions: 36%
  • Not enough patients making appointments: 33.6%
  • Patient no-shows and cancellations < 24 hours prior: 85%
  • Patient no-shows and cancellations 24 + hours prior: 41.3 %

When implemented correctly, teledentistry can help reduce the percentages of these common pain points.

Trouble Filling Vacant Staff Positions

While they were sitting on the bench during dentistry’s shut down, many dental providers, especially hygienists1, did a lot of soul searching and reevaluated their pre-COVID state of work/life balance, or more accurately, the lack of it.

The result: a large number of dental professionals decided either not to return to work or return only if certain terms and conditions were met. What’s more, in the post-COVID dental job market, quality of life assurances has become the new currency of employment negotiations. If cash was king, practice culture is equally important.

As staffing shortages continue, one thing is certain, DSOs will need to effectively meet this talent acquisition and retention challenge to regain a pre-COVID growth trajectory and equally important, to ensure the continuity of patient care.

Whether you operate a dental group of 10 locations or a DSO with 1,000 practices, deploying a secure enterprise-wide teledentistry platform, such as TeleDent by MouthWatch, may help address your teams’ work / life balance concerns through a concept I like to call “Virtual Flextime”. Here’s three ways to help make this new job perk a reality:

  1. Save Chairtime for Treatment – Providing chairside patient care is physically demanding, in fact a large percentage of dental professionals report long-term musculoskeletal disorders. Common occupational hazards of dentistry include back and neck pain and injury, and carpal tunnel syndrome. Chronic pain is one of the leading reasons why dentists, hygienists, and dental assistants exit their clinical careers early.

One way to prevent or reduce chronic pain is to provide the members of your dental team with a break from the ergonomic strain and repetitive stress of patient treatment. This can be made possible, while still remaining productive, if a portion of their workday or work week can be dedicated to conducting virtual patient encounters via teledentistry. Teledentistry days can be rotated so that everyone on your clinical team gets a break from the operatory.

  1. Create Fluid Work Schedules – Life today is complicated. There are more single working parents than ever before, and many seasoned dental team members are now caring for their aging parents. In addition, the new generation of dental professionals is demanding more flexibility and balance.

In the past, dentistry never provided a work from home option. But teledentistry can make it possible. Of course, the teledentistry home office equipment set-up must be adequate and professional parameters must be established, but the technology is already in place.

Also, if you are having difficulty finding qualified dental team members in the immediate area of a specific office location, you may be able to recruit beyond the reasonable commute radius if you offer a work from home option to help offset the commuting time and expense.

  1. Provide Virtual Team Support – Once teledentistry is implemented and a virtual consultation workflow is established, team members trained in teledentistry can be utilized to fill the staffing gaps in other locations without the need to travel.

Thanks to the virtual team support capability, the existing in-office team in an understaffed location can now focus on providing necessary services that can only be provided in-office for patients.

Meanwhile, virtual patient encounters can address common oral health concerns or determine what type of in-office care is needed by a team member from another location, even beyond traditional office hours.  Prioritizing and pre-determining care needs helps to streamline clinical care and make chairtime more effective and efficient.

It should be noted that once you implement teledentistry to meet your current staff and potential candidates where they are, you will be meeting your current and prospective patients where they are as well. Let’s take a closer look at how this provider / patient win-win can occur.

Making it Easier for Patents to Make Appointments

Thanks to teledentistry, there are several traditional in-office job functions that can be easily transitioned to virtual-first consultations, including new patient consultations, treatment plan presentation, specialist referrals, pre-op consultations, post-op consultations, oral hygiene coaching, and patient monitoring.

According to Fred Menko, Vice President, Growth Strategy and Experience, Advantage Dental+,  a DSO composed of more than 70 locations, over 200 providers and more than 600 support employees throughout five states, transitioning just 7% of in-office appointments to virtual encounters with TeleDent reduced the DSO’s annual cost of treating patients by 70%. Your accountant will love this. Moreover, the average teledentistry consultation is 15 minutes. What patient won’t love that?

Let’s face it, your patients are already scheduling virtual appointments with their medical providers and COVID demonstrated teledentistry is also a convenient and effective care model. Once you promote this option to current and prospective patients via your internal marketing efforts and also make it easy for them to request a teledentistry appointment via a web form (a TeleDent feature), you will be building a virtual appointment pipeline. Virtual appointments are not replacements for chairside treatment, but rather an effective means to tee up your in-office appointments and help fill your chairside appointment schedule and provide a convenient option that patients are seeking. 

Reducing Patient Cancellations and No-Shows 

Whether patients cancel their appointments with advance notice or simply don’t show up, it wreaks havoc on your schedule. Many times, this is because of a last-minute conflict or simply forgetting but very often it can be attributed to dental anxiety.

According to the 2017 Journal of Dental Hygiene survey, “The Prevalence of Dental Anxiety in Dental Practice Settings,” out of the 308 participants, 26 (8.4%) responded to missing a dental appointment due to dental anxiety. Five common themes were coded as the source of dental anxiety: fear of dental experience, previous negative dental experience, cost of treatment, gag reflex, and fear of bad news.”

The survey concluded that “Moderate to high dental anxiety was present in 19% of the population sampled. Awareness of patients’ dental anxiety level and the utilization of anxiety reducing measures during treatment may encourage routine care.”

Another reason for cancellations and no shows is that patients do not feel connected or engaged with the dental teams in your practice locations, which makes them feel less obligated to keep appointments.

Lack of connection also contributes to patient anxiety because they have not yet developed a level of trust that reinforces the feeling that their oral health is in good hands. This is especially true with new patients.

Regularly scheduled teledentistry touch points can not only help instill a strong level of trust, but also ensure that your patients are engaged and active stakeholders in their own oral healthcare which will make them more likely to keep their appointments. Here are some suggested teledentistry touchpoints that can be incorporated to help keep your schedules full:

  • New patient onboarding – “Welcome to our practice.” A one-on-one setting without PPE. This is especially helpful with pediatric patients and makes a personal connection. This also enables the patient’s or guardian to ask questions or express any concerns with greater comfort. convenience and ease.
  • Specialist introductions – “Meet Dr. Smith, my trusted periodontist colleague.” Enable a warm handoff and less stressful meeting with a new member of their oral care team prior to treatment.
  • Treatment Plan Presentation – “Let’s review our recommendations.” A more relaxed alternative for the patient than in a dental chair and include any decision makers in the conversation.
  • PreTreatment Consultation – “Don’t worry, here’s what you can expect.”
  • Patient Monitoring – “How are you doing?” Nothing says we care about you more than a virtual check-in.
  • Hygiene Education – “Let’s make your next hygiene appointment a great one!” Help make the patients meet their goals for improved oral health.
  • Patient Cancellation – “Thanks for the advance notice. Let’s schedule a quick virtual check-in, then reschedule.” Emphasize the importance of rescheduling while assessing if there are any immediate concerns.


A teledentistry solution such as TeleDent by MouthWatch is a useful tool that can help group practices and DSOs weather the storms of staffing shortages and unfilled patient schedules. TeleDent is cloud-based and can be accessed from anywhere. It is also HIPAA compliant and extremely secure wherever it is deployed, whether it be a dental office, community outreach clinic or home office. Schedule a quick demo to see for yourself.

About the Author: Jamie Collins, RDH-EA,BS, is a licensed hygienist in Idaho and Washington states dedicated to advancing the dental profession. With over twenty years in the dental field, Jamie continues to be involved in many aspects of patient care. Her passion for patient care, especially for those with higher risk factors, motivates Jamie to share tips and tricks of the dental profession. Through speaking engagements and writing over 80 articles for various publications, Jamie educates dental professionals worldwide. She is the recipient of the 2021 and 2022 ADHA Trailblazer Award and was the first recipient of the ADHA Standout Seven Corporate Hygienist award in 2022. Jamie is Director of Sales at MouthWatch, LLC ( and Dentistry One LLC (www.Dentistry.One) and can be contacted at