On any given morning in the U.S., a dentist unlocks the front door, scans the day’s schedule, and feels a familiar, lurching anxiety in the stomach. A gap at 10 a.m. An unexplained no-show at 2:15 p.m. A hygienist with an unexpectedly light column.
This unease is not born of failure. In fact, many of these same dentists have diligently invested in advertising, social media, websites, or the latest search engine optimization promises.
Sara Hansen.
New patients call, appointments get booked, the phone rings. Yet, the uncertainty persists: Why does a practice with new patient flow still feel unstable? Why, despite growth, does the bottom line fail to reflect it?
The problem is not volume. It’s not visibility. It’s not even competition.
The problem is that dentists are neglecting the people they’ve already earned. These are patients who don’t leave loudly; they quietly slip away when no one notices.
The acquisition trap
Dentistry, like much of healthcare, has long been captured by the pursuit of new business. The industry’s external marketing playbook: advertisements, postcards, websites, clicks, impressions … all of it teaches practices to think of growth as a numbers game.
And while we seem to exist in a field obsessed with acquisition, most dental practices are quietly sitting on hundreds of thousands, sometimes a million dollars in unaccepted or unfinished dentistry.
This is real dentistry that you diagnosed, never scheduled, and slowly buried under the day-to-day demands of a busy practice. The feather in your cap here is that these aren’t prospective strangers living across town. They are your patients with charts, histories, families, and intentions to return. Each of these patients has already walked through your door, but for one reason or another, fell away.
The dental profession has a word for this category: inactive. But what it really means is overlooked.
The real role of marketing
Marketing should not be treated as a collection of tactical widgets. It should function as the connective tissue of the entire patient journey.
A healthy practice doesn't spend the least on marketing. Nor does it spend recklessly. It invests with intention, beginning not with the outside world, but with the ecosystem that already exists.
The one marketing thesis every practice needs to memorize: Own your building before you try to own your neighborhood.
That means:
- Re-engage the people you already serve.
- Follow up on unscheduled treatment.
- Bring back those who've slipped away.
- Ask for reviews and referrals with sincerity, not gimmicks.
- Create experiences that make patients want to return.
Refocusing your marketing efforts this way is the opposite of glamorous (and it’s precisely for this reason that dentists tend to overlook it).
How to build a whole-practice marketing system
- Audit the buried opportunity. Count the unscheduled treatment. Identify the inactive patients. Determine where communication broke down. Practices are routinely stunned at what they find.
- Rebuild the internal marketing engine. This is not "marketing" in the commercial sense but relationship stewardship: It entails a follow-up call, a personalized message, a thoughtful text, a moment of human contact.
- Tie your marketing budget to the future you're actually building. Not the bare minimum. Not the maximum you can stomach. The number that aligns with your strategic goals, whether you're two years in or 20.
- Add external marketing only after internal systems stabilize. When you know your follow-up is strong, your case acceptance process is functional, and your patient communication is consistent, then you invite the outside world in.
- Reassess as the practice evolves. Young practices have different needs than mature ones. Marketing should grow up alongside the business, not run ahead of it.
The cost of inaction
If you don’t own your marketing system, you will own the regret that follows. Not because marketing determines a practice’s destiny, but because a lack of marketing coherence slowly erodes it.
A missed follow-up here, a lost referral there, an unsent reminder, an abandoned treatment plan are not errors. They are tiny leaks in a boat that otherwise appears seaworthy, but over time, they sink the ship.
Dentists who embrace a whole-practice marketing system report outcomes that sound less like growth hacking and more like restoration. Some aftereffects include:
- A fuller, steadier schedule
- Lower overhead ratios
- Increased case acceptance grounded in trust, not pressure
- Better patients (those who understand, value, and pursue comprehensive care)
- A practice that compounds value instead of chasing volume.
True marketing shows up as stewardship: the deliberate, thoughtful tending of the people who have already placed their trust and confidence in your practice.
What happens if you don't change?
What’s the worst that could happen? You continue operating as you have. Gaps in your unstable schedule will pop up from time to time, and you’ll have to learn to live with it, no matter how many new patients come through your door.
Unchecked, external-only marketing creates a treadmill effect: You’ll run harder, spend more, and hope the next ad brings the right people. The practice becomes busier but not healthier; visible but not valued.
The "regret" I refer to earlier in this article isn’t dramatic. It’s quieter, more insidious. It’s the realization, years later, that the value you sought outside your walls was sitting inside them all along.
In a sense, the story here extends far beyond dentistry. It echoes a cultural truth about growth, ambition, and modern business: We are conditioned to seek expansion outward, not inward.
Often, the most transformative gains come not from acquiring more but from caring for what we already have. Dentistry is no different. A practice grows when the trust it has earned is honored, protected, and reactivated.
The world will always encourage you to chase new patients, but the healthier, wiser, and more sustainable choice might be to invest in the people who have already chosen you.
Sara Hansen is the senior marketing adviser for Phoenix Dental Agency. Combining her expertise in developing detailed marketing plans with a track record of propelling practices to achieve success through marketing, she is committed to crafting individualized marketing plans that guide dentists in becoming the dental authority in their communities.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
