Introduction
The dental industry today is undergoing a sweeping transformation due to a convergence of factors that include increased public awareness of oral health, rapid advancements in clinical technology, instant access to information, evolving consumer expectations, and growing competition1. For practicing dentists, this shifting landscape brings considerable pressure to adapt, as well as the realization that remaining static could result in declining patient retention, satisfaction, and financial performance. For many, the challenge is heightened when working in isolated settings where broader trends may be hard to assess. Nevertheless, adaptation is critical to ensuring the long-term health of both patients and the practice itself.
The good news? Every dental office has an underutilized tool at its disposal: its patients. Regularly conducted patient satisfaction surveys can offer invaluable insights into patient sentiment and can reveal actionable opportunities for improvement. These surveys enable dental offices to identify both strengths and areas for growth, enhance service quality, and ultimately safeguard their practices. This article will explore the importance of measuring patient experience in dentistry, the development and science behind “customer satisfaction” tools, and why the Net Promoter Score (NPS) model has emerged as the standard in the field. We’ll also look at best practices for using NPS and other survey tools to optimize both patient experiences and business outcomes.
Why patient experience is critical in dentistry
Compared to hospitals and medical clinics, where patients often seek treatment out of necessity, dental patients in North America are more likely to seek out preventive or elective services, which shapes their approach to oral health and influences their expectations.2 In Canada, for instance, according to the Statistics Canada 2022 Annual Health survey, individuals aged 12–49 are more likely to have visited a dentist within the last year than a doctor in any other specialty. This shift is not just because of the widely recognized link between oral and overall health but also because preventive measures are increasingly perceived as essential for maintaining oral health, not simply restoring it after issues arise3.
This cultural shift offers an advantage to dental practices: many patients come proactively to maintain functional, aesthetic, and healthy smiles vs. those dealing with oral diseases, where treatment focuses on both maintenance and enhancement. However, this trend also means that dental care has become more consumer-driven, making patient satisfaction paramount. Younger patients in particular have higher expectations; they seek not only medical care but also an experience that aligns with their lifestyle values: convenience, customer service, aesthetics, and even social media-worthiness play a significant role in shaping their loyalty4. Thus, the equation that determines satisfaction (i.e., perceived experience – expectations), must be understood and optimized5. Dentists who measure their patients’ expectations and perceptions proactively and systematically will hold a significant advantage.
The evolving landscape
In addition to shifts in patient expectations, the competitive landscape has become more transparent and immediate.6 Access to information about other dental practices, including reviews and ratings, means patients can easily compare options and make quick decisions. In the past, marketing for dental practices was limited to the Yellow Pages, a community newspaper ad, or perhaps sponsoring a local sports team. Today, practices need to invest in online presence, reputation management, and social media engagement, particularly in crowded metropolitan and suburban markets.
For patients, locating a new dental office requires minimal effort. A quick Google search will present nearby options almost instantaneously. Dissatisfied patients, therefore, have the power to switch practices with little to no personal cost. This easy accessibility to competitors’ contact information highlights the importance of focusing on patient satisfaction (and expectations) as intensely as clinical competency. Many dentists share goals of cultivating patient loyalty, generating word-of-mouth referrals, and offering an exceptional “customer experience.” The foundation of all these efforts, however, is in understanding patient sentiment—a factor that can only be effectively managed if measured.
Customer satisfaction surveys: An overview
Customer satisfaction has long been recognized as a “strategic asset” across industries.7 The American Customer Satisfaction Index (ACSI) defines it as such, emphasizing that understanding customers’ preferences and expectations allows organizations to modify their services accordingly. This philosophy is backed by heavy investments from large corporations in senior positions like Chief Experience Officer, highlighting the central role customer experience plays in today’s business landscape. Influential business leaders have long emphasized the importance of “knowing your customer”. Mercedes Benz USA, CEO Steve Cannon is quoted as saying “customer experience better be at the top of your list when it comes to priorities in your organization.”
The value extends to healthcare as well, as patients—especially younger generations—expect an experience akin to the customer service standards seen in other service sectors8. Dental practices that neglect to measure satisfaction may avoid doing so out of fear of negative feedback. Giving in to the ostrich instinct would be a mistake. Feedback from dissatisfied patients, as Bill Gates wrote in his book Business @ the Speed of Thought, can be most instructive: “Your most unhappy customers are your greatest source of learning.” By using patient surveys, dental practices can validate areas where they excel and, more importantly, gain insights into areas needing attention.
Patient satisfaction surveys in healthcare
Elite healthcare institutions understood the need to measure PX years ago. Mayo Clinic, a global leader in patient care, has an entire team dedicated to collecting patient feedback to enhance care.9 In the U.S., more than 4,400 hospitals participate in the HCAHPS survey10, which allows standardized comparisons across hospitals, enabling benchmarking and fostering transparency in healthcare.
In dentistry, however, there is comparatively little standardization in PX surveys, particularly in Canada. No central repository exists to compile patient feedback, meaning that individual offices lack a benchmark to measure themselves against. The existing literature is also limited; much of it is either outdated or focused on satisfaction with specific interventions like dental implants or orthodontics, rather than on the broader PX. Where broader studies do exist, they often draw from other countries or general healthcare research, leaving a gap in understanding the unique experiences and expectations of Canadian dental patients in family practices.
Nevertheless, a review of the available global literature reveals key findings, such as the correlation between patient satisfaction and retention. In Australia, for example, dental practices are encouraged to assess their performance against the National Safety and Quality Health Service (NSQHS) standards.11 Analysis of the NSQHS data reveals, among other things, that factors such as a patient’s subjective perspective of their dentist’s “ability to really listen to patients” are as important as the clinical competence of the treatment received when predicting whether that patient will refer the clinic to friends and families. While provocative, the most important insights for each practice will come from data closer to home—ideally, from a practice’s own patients.
From a risk management perspective, surveys enable the early identification of dissatisfied patients and failed treatments, providing an opportunity to address concerns before they escalate into more significant issues like formal complaints, attrition or malpractice suits. Such information is critical in guiding timely and targeted improvements, for example, in larger clinics after hiring a young associate. Notwithstanding the shrinking gap in the scientific literature, PX is widely considered “an integral component of healthcare quality”12.
Introducing patient sentiment measures in dental offices
Dental offices can use various methods to administer surveys, such as online platforms, in-office kiosks, or follow-up messages after appointments. Each method has advantages and challenges. Online surveys are convenient and cost-effective but can have lower response rates, while in-office surveys capture immediate feedback but might reflect the patient’s mood at the moment rather than their overall satisfaction with the clinic.
Collecting and processing this data, however, can be an obstacle, especially for smaller practices. When it comes to the ability to capture and analyze large amounts of patient data, belonging to a network or other large organization brings advantages. Dental support organizations, (DSOs), for instance, may have both the infrastructure and wherewithal to analyze survey data at scale. Options do exist for smaller clinics wishing to benefit from patient sentiment studies; third-party services offer affordable options to help interpret the data and make it actionable. By using appropriate methods and means, practices of all sizes can gather critical insights without overwhelming their resources.
Consistency is key to effective patient satisfaction surveys
As indicated, patient satisfaction surveys come in many forms, yet they share a common goal: to evaluate various stages of the patient journey, which begins well before a patient steps into the office. Some surveys consist of multiple questions to gauge different aspects of the experience, while others, like the NPS survey, ask a single key question to determine patient loyalty:“on a scale of 0 to 10, how likely are you to recommend our practice to a friend or colleague?”13. By consistently administering these surveys, practices can track progress over time, monitor the impact of any changes to clinical or administrative practices, and adapt without disrupting the data with too many new variables. Consistency allows practices to build a clearer picture of patient satisfaction and identify meaningful trends in their patient base’s perceptions.
The Net Promoter Score (NPS)
The NPS was developed by Satmetrix and by Fred Reichheld; it was introduced to the business world in 2003 in Reichheld’s Harvard Business Review article, “The One Number You Need to Grow.” Over the past 20 years, NPS has become an almost ubiquitous tool across industries. And its broad adoption means that it is backed by a substantial and growing body of evidence. The NPS asks “How likely are you to recommend our practice to a friend or colleague?” Responses are then classified into three categories—Promoters (9-10), Passives (7-8), and Detractors (0-6). Scores falling in the “passives” range are ignored. The NPS is calculated by subtracting the percentage of Detractors from the percentage of Promoters, yielding an objective and easily benchmarked score of -100 to +100. A positive score signals higher satisfaction and loyalty, while a negative score indicates areas for improvement.
For healthcare businesses, including dental practices, NPS is an effective yet simple tool that provides a clear snapshot of patient loyalty and satisfaction. Studies link high NPS scores to increased business growth, demonstrating that patient sentiment can be a predictive indicator of success.14 By identifying areas for improvement, NPS surveys can enable practices to enhance their services and foster a culture of continuous improvement.
Practices may choose to supplement NPS with additional questions to understand the reasoning behind a patient’s score. By identifying strengths and areas for growth, practices can adapt to better serve their patients and improve retention.
Integrating patient satisfaction surveys and NPS in dental practices
Collecting data effectively is the first step in integrating patient satisfaction surveys into dental practices. Best practices for survey distribution and response collection include choosing the right timing, ensuring privacy and confidentiality, and using multiple channels to maximize response rates.15 Once the data is collected, it is crucial to analyze and act on the feedback. Interpreting survey results and NPS data will reveal patterns and trends that should inform decision-making and enhance patient’s overall experience.
For example, survey data may highlight the need for adjustments in appointment scheduling, suggest the need for customer service training for front-office staff, or indicate that the office environment could benefit from enhancements. By acting on patient feedback, dental practices can make targeted changes to improve the overall PX, which should yield financial and professional benefits as natural outcomes.
Conclusion
In today’s competitive dental market, patient satisfaction surveys, particularly those that measure NPS, have become indispensable. These surveys offer critical insights into patient perceptions, helping practices identify areas for improvement, foster loyalty, and strengthen patient relationships. As patients with positive experiences are more likely to return and refer others, satisfaction surveys also contribute to broader health outcomes and practice sustainability.
Positive PX leads to increased visits, better oral health, and by extension, improved overall health. As a result, dental practices are encouraged to use patient satisfaction surveys and NPS to build resilient, patient-centered operations. Embracing patient sentiment as a science allows practices to enhance satisfaction, increase loyalty, and create a stronger foundation for long-term success.
About the authors
Julian Perez, Chief Risk and Compliance Officer at Dentalcorp; Rebecca Sampson, Vice President of Marketing at Dentalcorp. Dentalcorp is Canada’s largest and one of North America’s fastest growing networks of dental practices. Dentalcorp acquires leading dental practices, uniting its network in a common goal: to be Canada’s most trusted healthcare network. To learn more, visit dentalcorp.ca.