4 Letters That Spell Treatment Acceptance: PCSB

Recognizing that a significant number of patients hesitate to proceed with necessary treatments, we reached out to the Team Training Institute to share their expert advice on how to bridge this gap. Below, they discuss strategies that dental practices can adopt to not only better understand patient needs, but also to improve overall patient health outcomes. 

With the average restorative case acceptance rate for dental practices at just 40%*, less than half of patients are moving forward with the treatment they need. Even in the top 10% of practices, case acceptance only jumps to 59%*. In order to support patient health and practice health, we need to find ways to ensure patients get the care they need, when they need it. When practices request our help with case acceptance, our most common finding is a lack of practice systems. With the right systems in place for patient education and financing options that address patients' budgets, patients are comfortable moving forward with recommended treatment.

Patient education and communication are among the most critical systems to boost case acceptance; patients don't accept treatment they don't understand. 

At the Team Training Institute, we use the PCSB framework to help patients understand why treatment is necessary and create a sense of urgency which then drives action. PCSB represents Problem, Consequence, Solution, Benefit – the four keys to comprehensive patient education. Most dentists thoroughly explain the problem and the solution, but many miss the emphasis on consequences, which can be the most relevant component of the patient's decision. 


P – Problem

Explaining the problem is an important first step. However, to truly help patients understand the problem, you have to engage them in the discussion. Remember to strive for "talking" instead of "telling".  Asking simple questions like, "have you noticed…" or "does that concern you…" can draw out patient feedback that you can refer to when proposing the solution/ treatment. It can also help ensure the patient is still following your presentation and hasn’t disengaged from the conversation. 

Helping patients visualize the problem is critical to comprehension. Enlarging images so patients can see what you see in their mouth helps to build trust while also giving the patient an opportunity to express their own concerns about what they see. Some practices we work with will even place the patient’s image next to an image of a healthy mouth, so the patient can compare them side-by-side and start to identify problems themselves.  


C – Consequence

Consider how many dental conditions get better with time. Not only do they not get better with time, but they usually get more complicated and more expensive to fix. This is a significant reason why the consequences of inaction are critical to your case presentation. Walk the patient through what happens if their condition goes untreated. This isn't a scare tactic - you're simply sharing what you know to be true, just like your diagnosis of the problem. Make sure you allow time to thoroughly address any patient questions or concerns. 

How can you tailor the consequences to focus on what’s most meaningful to the individual patient? In most cases, there will be both health and aesthetic consequences to a lack of treatment. When we know the priorities of our patient, we can lead with what matters most to them. 


S – Solution

When the consequences have been thoroughly explained, typically patients will then ask you for the solution. Have a consistent solution for your most common problems and present one option based on the best possible care for that patient. Create a sense of urgency, but be willing to work within a timeline and a financing model that’s comfortable for the patient.  


B – Benefit

Wrap up the treatment presentation by explaining how the solution helps them avoid the consequences. The benefit is often just an overall statement of why treatment is good for them. This is where support from the dental team is critical. During their interactions with the patient, they can reinforce how they've seen the solution benefit other people with their condition and position the dentist as the expert in delivering that solution. The team can also help elicit any lingering questions the patient may not have been comfortable voicing to the dentist.  


When using this framework, most of your time should be spent on the problem and its consequences for the patient - that's what is most important to them. Watch for a tendency to overly focus on the solution. The solution is where dental terminology often goes over the patient's head, leaving them confused. Keep the solution as simply stated as possible. Then, if you've thoroughly covered the consequences, the benefit will be a short inversion of those consequences. 

To implement this system in your practice, identify the most common conditions you treat, and develop your own PCSB framework for each of those conditions. Practice these scenarios as a team so everyone is using similar language to create consistency for the patient. For more help increasing case acceptance in your practice, visit  


About The Team Training Institute

At The Team Training Institute, we work with dental practices around the country to make sure their offices run smoothly and profitably each day. We provide teams with the processes and systems they need to deliver excellent care, operate efficiently, and build a successful practice in the community. 

*Data provided by Dental Intel.