A good dental treatment plan answers four questions before the patient asks them: what is wrong, what we propose, what it costs, and when it happens. This page gives you a free template that covers all four, a filled-in example, and the mistakes that make patients say "let me think about it".
Written by the DentClosers team. The example below is fictional and shows the format only. Treatment decisions belong to the treating dentist.
The template
Copy this into your document, or use it as a checklist for whatever system you use.
1. Patient and case
| Field | Fill in |
|---|---|
| Patient name | |
| Date of examination | |
| Treating dentist | |
| Numbering system used | FDI / Universal / Palmer |
| Records reviewed | Panoramic x-ray, photos, CBCT (if any) |
2. Findings (current situation)
| Tooth | Finding | Note |
|---|---|---|
3. Proposed treatment options
| Option | Treatment | Teeth | Materials / brand | Price |
|---|---|---|---|---|
| A | ||||
| B |
4. Visit schedule
| Visit | What happens | Approx. duration | Healing before next visit |
|---|---|---|---|
| 1 | |||
| 2 |
5. Price summary and terms
| Item | Amount |
|---|---|
| Option chosen | |
| Total | |
| Deposit to confirm | |
| What's included (hotel, transfers, temporaries, follow-up) | |
| Plan valid until |
6. Signature / acceptance
Patient acceptance, date, and the option chosen.
A filled-in example
Fictional patient, fictional prices, format illustration only.
Findings
| Tooth (FDI) | Finding | Note |
|---|---|---|
| 36 | Missing | Lost 2 years ago |
| 46 | Non-restorable fracture | Extraction advised |
| 11, 21 | Old composite fillings, discoloured | Patient wants aesthetic improvement |
Options
| Option | Treatment | Teeth | Materials | Price |
|---|---|---|---|---|
| A (Standard) | 2 implants + 2 zirconia crowns; 2 zirconia crowns front | 36, 46; 11, 21 | Standard implant brand | €3,100 |
| B (Premium) | Same plan with premium implant brand | 36, 46; 11, 21 | Premium implant brand | €3,900 |
Visits
| Visit | What happens | Duration | Healing |
|---|---|---|---|
| 1 | Extraction 46, implant placement 36 + 46, temporary crowns 11, 21 | 5 days | about 3 months |
| 2 | Final crowns on implants, final crowns 11, 21 | 7 days | none |
Terms: deposit €300 to confirm, airport transfers and hotel included, plan valid for 14 days.
Five mistakes that cost acceptance
- One lump price. "€3,900 for everything" invites the question "for what?". Itemise by tooth and treatment.
- No options. A single plan forces a yes or no. Two options, standard and premium, turn the decision into a choice. Most patients pick one instead of leaving.
- Hidden logistics. International patients need visits, healing time and travel on the same page as the price.
- Wrong numbering for the audience. US patients know the Universal system, most others know FDI. Say which one you use. Our interactive tooth chart converts between them.
- A PDF in a chat. A PDF gets lost in WhatsApp. A plan page the patient can open, compare and accept online converts better, as we explain in stop sending PDFs.
Doing it without a template
Templates work, but every plan gets typed by hand and every price checked by memory. In DentClosers treatment plan software the dentist marks findings on a tooth chart, the plan builds itself with the clinic's own prices, options A and B are generated side by side, and the patient receives a plan page they can accept online.
Keep going: the numbers behind plan acceptance are in how to increase case acceptance, and pricing presentation for big cases in how to present All-on-4 prices.