Reimagining the Dental Front Office

The dental profession has an impressive history of clinical advances, but, on the business side, dental practices have not been early adaptors. In fact, since the widespread introduction of telephones in the 1920s, very little has changed in the way dental offices conduct their business. Employees are now aided by computers, but the basic tasks performed at the front desk—such as answering the phone to schedule patients and collecting payments—remain the same.

The rise of artificial intelligence is changing all businesses, and dental practices are not immune. Rapid shifts in technology are fueling a movement to a self-service economy, which will result in very different roles for the dental administrative team.

Remember when buying an airline ticket involved contacting a travel agent? You would call the travel agent, who checked available flights, times, and airfares, and the two of you would work together to decide on the flight to be booked. Decades ago, the travel agent was consulting printed airline schedules, but over time the entire process became computerized. When you asked about flights, the agent used a computer to answer your question. To book a ticket, the agent pushed a button to purchase the ticket on your behalf. As computers became ubiquitous, people realized that they could eliminate the middleman. Why call a travel agent and ask that person to read options from a computer screen and then confirm a ticket purchase, when the traveler could do the same thing on his or her computer?

That process has now evolved: People have handheld tablets and cell phones. There are also numerous websites that compare fares and display options, a computational feat much faster than anything a human travel agent could accomplish. As a result, travel agents are forced into smaller and smaller niches—booking cruises, tours, or international trips with complex itineraries. If you just want to buy a plane ticket to visit a relative or go on a business trip, it’s all self-service.

The self-service economy manifests itself in so many other ways:

  • Retail stores such as Home Depot and Target are phasing out cashiers. Those self-service checkout kiosks, a novelty just a few years ago, are displacing their human counterparts.
  • Amazon Go is pioneering grocery stores that take the checkout process a step further. Not only are there no cashiers, but the customer does not have to scan anything. Once you remove an item from the shelf, it goes into your electronic “cart.” Your final bill is tallied, and your credit card is charged. Have a nice day.
  • Delta Airlines announced that it is testing facial recognition software to check in passengers traveling from Atlanta to Paris. Passengers have the option of speaking to a human agent, but 98% of passengers choose self-service. The airline reports that the use of facial recognition saves an average of two seconds per passenger, which adds up to a total of 9 minutes faster boarding of a wide-body plane.
  • Fast food restaurants such as McDonald’s are also moving to self-service ordering. Instead of the customer giving the order to an employee who presses buttons on a computer, the customer completes the order using a touchscreen and pays at the kiosk with cash or a credit card.
  • Starbucks and countless other establishments accept Apple Pay. No need to fish around in a wallet or purse for coins or cards; just swipe your cell phone under a reader and your latte is paid in full.

Self-Service Dentistry?

The self-service revolution is already disrupting the dental profession. The technology necessary to allow patients to book appointments online is not new, but many practices have resisted the change. In a profession that has traditionally been dominated by one-doctor practices, there is no economy of scale. Change occurs one practice at a time. In addition, many practices, even larger independent groups, have convinced themselves that patients do not want to make their own appointments. Their reasoning is that many older patients, for example, want to speak to a real person on the phone.

The self-service revolution is already disrupting the dental profession.

Reality, as usual, is more nuanced. There are some patients who want to talk to a team member on the phone to ask questions before making an appointment. Patients should certainly have that option. However, there are other patients who decide late at night or over the weekend that they are ready to make a dental appointment. When patients are ready to appoint, especially after regular office hours, why shouldn’t they have the option of scheduling using their phone? Patients, even older patients, are already accustomed to making appointments with physicians, hairdressers, and auto mechanics online. They expect the same accommodation from dental offices.

A dental practice can limit online appointments to patients of record and show only certain times as available to the online viewer. Whether the online booking option is tested first and rolled out slowly or made widely available at the outset, self-serve dental scheduling is spreading very quickly. Larger practices, especially corporate entities, are driving this change because they are professionally managed by people who see the value of marketing and reducing barriers to entry.

While self-service appointments have lagged in dental practices, the automated confirmation process is much more widespread. It started with automated phone calls, then progressed to emails, and text messages. All options are still possible, but text messaging is becoming the preferred way to confirm appointments. Patients can be notified multiple times, if they so choose; and the software will even send a final reminder text to the patient just hours before the scheduled appointment.

As with all automated systems, its use is on a continuum. There are some people who prefer to get a call from a live person, even though most people are quite comfortable receiving text messages. Some confirmations will be better handled by staff to accommodate the preferences of certain patients, but the unmistakable trend is toward more automation, not less.

There are some practices, especially in pediatric dentistry and orthodontics, that use self-service check-in to great advantage. The patients and parents do not have to wait while a receptionist finishes a call to check in a patient because check-in is accomplished via a self-service screen. In Helsinki, Finland, there is a medical-dental complex that takes this concept to the next level. There is no receptionist. Patients enter and check in using a kiosk. Someone appears and escorts the patient to the proper medical or dental treatment room. Dental practices may want to keep the receptionist to convey a sense of warmth and welcome, but that person should not have to multitask to the point of distraction, especially when so many tasks can be automated.

One of the challenges of running a dental office is to reduce bottlenecks. The front desk of a dental practice often has the uneven pace of a war zone—periods of inactivity are interrupted by moments of panic. When two people are checking in, and two people are checking out, it seems that everyone decides to call the office at the same time. At times like these, even the best administrative team members are challenged.

More Changes Ahead?

If check-in and confirmation are automated, the last two remaining challenges are insurance issues and collecting payments. The insurance industry is finally beginning to yield to demands for transparency. If a customer is shopping in Walmart and wants to know if an item is available at a lower price online or at a different store, that shopper can easily compare prices on the spot using a mobile phone. There are customers in stores such as Target who are not at all shy about showing their phone to an employee and asking, “Can you match the price of this item that I found online?” 

Dental insurance has long been a Byzantine world of claim submission, follow-up, waiting, and frustration. Thanks to new software, however, the same transparency that one expects when shopping for items in a store or online is coming to the world of dental third-party reimbursement. The dental profession is on the cusp of being able to tell patients routinely, in real time, consistently and accurately, how much their insurance will pay for a certain procedure. Even more significant, patients will soon have this information at their fingertips. They will know the amount of their benefits and out-of-pocket obligations and make informed purchasing decisions without the delays that currently stretch into days or weeks.

Stopping at the front desk to pay on the way out will also soon be optional—not because the payment will not be collected but because it will either be collected automatically (with the patient’s advance approval) through an app at the time of service, or the patient will use a service such as Apple Pay when leaving the office to scan, pay, and go. The date and time of the next appointment will be sent to the patient via email or text, and the confirmation system will be in place to issue reminders as the appointment date draws near.

Will AI Replace the Dental Team?

Some fear that the combination of automation and self-service, all products of artificial intelligence—the same type of technology that has brought Siri and Alexa into our lives—will make dentistry less personal. The argument is that patients will be interacting with machines, not people. While this trend will no doubt be more efficient by saving time for the patient and the practice, it is reasonable to ask whether the traditional bond between dental professionals and patients will weaken over time.

As the business community writ large engulfs dentistry and brings it into a brave new world, the self-service dental office will become the norm.

I have a different perspective on the effect of artificial intelligence on the business side of dentistry. At present, we are living in a hybrid world. Computers are providing self-service opportunities to a greater or lesser extent in some dental offices, but we still have talented team members who are pushing buttons to perform tasks such as scheduling—much like yesterday’s travel agents were the intermediaries between clients and computers. As the business community writ large engulfs dentistry and brings it into a brave new world, the self-service dental office will become the norm.

The next logical question is, “What is going to happen to the administrative team members in dental offices?” There may be some displacement, but by and large, the collective human talent in dental offices should be better utilized, not discarded. In a world where the rote and mundane shrink as a percentage of daily duties, there will be much more time for quality patient interaction.

Think of the anxious patient who arrives in today’s dental office and is greeted by a compassionate and competent staff person who nonetheless has to answer phones and track down insurance claims. If that administrative team member had more time, then there could be more meaningful patient interaction, perhaps time for a real conversation—even a sit-down chat in a consult room to review what will happen on the first visit and put the patient totally at ease. This type of quality human interaction sets the stage for meeting the doctor and forming a relationship. It is a much better use of staff time than asking patients on the phone umpteen times a day, “Do you prefer mornings or afternoons?” 


The reimagined dental front office of the (very near) future need not displace human beings or make dental practices less personal. On the contrary, with the creative use of the practice’s most precious resource—human beings—the modern practice will use technology to liberate team members from routine tasks and allow them the time to provide an even higher level of personal service to patients.