I often speak to my clients, pointing out that their patient databases contain massive potential for growth. Those existing patients must be recognized as superb opportunities.
to grow the practice further. Yet the “database patients” seem to collect dust. Substantial production opportunities are also missed because of low rescheduling numbers. Let’s look at the whole picture.

In addition to the patients you already have, there are only two ways to boost production in a dental practice: increase the number of patients or raise the output per patient per visit.

Most practices are OK at attracting new patients, but they need help retaining and rescheduling both new and existing patients. Even with new solid patient growth, a high patient attrition rate often leads to stagnation or decline in overall development.

So, why aren’t new patients the key to growing your practice?

While new patients are essential, —they need dental care just like existing patients. Adding new patients can support growth but should be part of a broader strategy.

Here’s what data from thousands of U.S. practices tells us about new patients:

• They have higher cancellation rates.
• They’re less likely to accept treatment or schedule follow-up appointments and often cancel treatment before it begins.
• New patients are more complex to retain and more likely to leave when another dental office makes an enticing offer.
• Onboarding new patients takes more time—tours, relationship-building, insurance verification, and paperwork—which reduces production per hour.

In essence, many practices are trying to fill a bucket with holes. Instead of focusing on fixing the leaks (retaining and scheduling existing patients), they keep pouring in more water (new patients). The smarter approach is to seal the leaks first, then add new patients if there’s still availability on the schedule.

Here’s the truth: There is no magic solution.

If adding new patients isn’t the key to production growth, what is? What reliable strategies can help you achieve these goals?

A dental practice owner shared an eye-opening experience. He asked his office manager how many of their patients had upcoming appointments. Her confident response? “All of them!” But when pressed, the owner revealed that only 40% of their active patients had scheduled future appointments. That isn’t unusual—many practices find themselves in similar situations. So, what’s the solution?

The most important metric you should track is the Pre-Appointment percentage.

This measures the percentage of active patients (those seen within the past 18 months) who have a scheduled appointment. If you monitor this regularly, you’re gaining opportunities. Data shows that practices with a Pre-Appointment percentage of 65% or higher drastically reduce patient attrition and save thousands in marketing costs.

In another practice, they increased their Pre-Appointment % from 40% to over 90% in just one year. Once they had the correct data, they could take the proper steps to solve the problem. A crucial part of their success was focusing on hygiene re-appointments. Hygiene Re-Appointment % is the percentage of hygiene patients who schedule their next appointment before leaving the office. This small change had a significant impact on their overall pre-appointment rate.

Other crucial metrics to monitor are Cancellation % and No-Shows.

It’s common to see several cancellations or no-shows on the schedule every Monday, but the genuine concern should be how many canceled appointments have yet to be rescheduled.

How many of your canceled appointments have been rescheduled?

In many cases, 50% or more of canceled appointments are never rescheduled, meaning missed production opportunities.

For example, if only 20% of your active patients have a future appointment. You should be excited! That means your practice has significant growth potential.

Are you spending time and money attracting new patients while the real value lies in recapturing existing patients without scheduled appointments? Some practices leave millions of dollars in unscheduled treatment on the table by not focusing on bringing back these patients.

Now what?

It’s time to focus on the patients you already have. By improving retention, re-appointments, and follow-up, you can unlock growth and increase production more effectively than relying solely on new patient acquisition.

Why not look at what we do and what we offer that other marketing agencies will not?