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  Posted by: Dental Design      13th April 2024

Missed appointments are the blight of many a dentist’s day

An NHS dentist in Somerset recently threatened to stop treatment for patients who miss appointments – after an ‘unprecedented’ number of ‘no shows’. Clevedon Dental Clinic issued the warning after a large number of people failed to attend appointments or cancelled them at the last minute.[i]

There are various reasons why people miss dental appointments, and it is important for dental professionals to understand these factors in order to effectively address them and ensure that patients follow through with their scheduled visits. By identifying these reasons and implementing proactive measures, dentists can help reduce missed appointments and provide better oral care for their patients.

One UK study found that children represent the higher proportion of missed appointments (21.3%) compared with adults (15.9%). It also found that male adult patients were 20% more likely than female patients to have at least one Did Not Attend (DNA) in the defined period.[ii]

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One common and simple reason why people miss dental appointments is forgetfulness. With the busy lives that people lead today, it is not uncommon for appointments to slip their minds. To address this issue, dentists can implement reminder systems. This can include sending text message reminders a day or two before the appointment, or utilising automated phone-call systems to remind patients of their upcoming visit.[iii]Additionally, dentists can provide patients with the more traditional appointment cards to serve as a visual reminder.

Another factor contributing to missed dental appointments is fear or anxiety.[iv] Dental anxiety is a legitimate concern for many individuals, and it can be a significant barrier to seeking necessary oral care. Dentists can help alleviate this fear by creating a welcoming and comfortable environment in their practice. This can be achieved by providing calming music, reducing waiting times, and ensuring that staff members are empathetic and attentive to patients’ needs. Communicating with patients to address their concerns and explaining procedures in a clear and concise manner can also help reduce anxiety, making patients feel more at ease during their visit.

Financial constraints can also lead to missed dental appointments.ii One way to address this issue is by offering flexible payment options such as dental plans and insurance policies. Communicating the availability of these flexible payment plans to patients can alleviate financial concerns and make dental care more accessible to individuals who may otherwise miss appointments due to cost concerns.

Flexible approach

Additionally, life emergencies or unexpected events can genuinely lead to missed dental appointments. While dentists cannot control external factors that disrupt an individual’s schedule, they can implement policies to accommodate unforeseen circumstances. For instance, setting up a cancellation policy that allows patients to reschedule their appointment without penalty – if they provide adequate notice – can help reduce the likelihood of missed appointments. This flexible approach not only shows understanding and empathy but also encourages patients to prioritise their oral health by rescheduling their appointment rather than completely missing it.

NHS dentists are not entitled to charge patients for DNAs or cancelling appointments. However, they can terminate the treatment of patients who fail to attend and have the right to ask the patient to find another dental surgery.[v]

AI to the rescue

The advent of artificial intelligence (AI) may well save the day. A new AI-based system predicts likely missed appointments and offers back-up. Through algorithms and anonymised data, the technology breaks down the reasons why someone may not attend an appointment – using a range of external insights including the weather, traffic and jobs. The appointments are then arranged for the most convenient time for patients. For example, it will give evening and weekend slots to those less able to take time off during the day.

This exciting development also implements intelligent back-up bookings to ensure no clinical time is lost, maximising efficiency. It is currently being piloted in Mid and South Essex NHS Foundation Trust, which supports a population of 1.2m people, with an average DNA rate of 8%. When used at full scale, it is predicted to allow an additional 80-100,000 patients to be seen each year at the trust. The software, created by Deep Medical and co-designed by a frontline worker and NHS clinical fellow, is set to be tested at five additional trusts from this year.[vi]

As previously mentioned, improving patient communication is a key element to reducing DNAs. Using AI-based Kiroku Docs can help with just that. With it, dental professionals are able to easily produce customised referral letters, consent forms, treatment planning letters and patient information documents through the data collected in Kiroku Notes. It can translate dental terms into patient-friendly language too, helping you to improve communication with your patients. For example, the notes might say ‘Caries: UR4 DO’ but the patient letter will read: ‘There is decay affecting your upper right first premolar tooth.’ Good communication skills have been proven to nurture patient satisfaction,[vii] helping to foster a positive dental experience and potentially fewer no-shows.

Understanding the various reasons why people miss dental appointments is crucial for dentists to address this issue effectively. By implementing reminder systems, creating a welcoming environment, offering flexible payment options and accommodating unforeseen circumstances, dentists can help reduce missed appointments and ensure that patients receive the oral care they need.

To find out more about Kiroku, or to start your free trial, please visit

[i] Somerset Live

[ii] West A, Stones T, Wanyonyi K, Deprivation, demography and missed scheduled appointments at an NHS primary dental care and training service, University of Portsmouth Dental Academy, University of Portsmouth, [Accessed January 2024]

[iii] Sumanth Prasad, Richa Anand, Use of mobile telephone short message service as a reminder: the effect on patient attendance, International Dental Journal, Volume 62, Issue 1, 2012, Pages 21-26, ISSN 0020-6539, [Accessed January 2024]

[iv] Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23(4):295-301. doi: 10.1159/000357223. Epub 2013 Dec 20. PMID: 24356305; PMCID: PMC5586885. [Accessed January 2024]

[v] NHS England

[vi] NHS England

[vii] Lang EV. A Better Patient Experience Through Better Communication. J Radiol Nurs. 2012 Dec 1;31(4):114-119. doi: 10.1016/j.jradnu.2012.08.001. PMID: 23471099; PMCID: PMC3587056. [Accessed January 2024]

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