Thursday Troubleshooter: How can new dentist inform patients about x-ray changes?

QUESTION: I’m taking over a practice where dentists won't confront patients who refuse to take x-rays. How should I phrase this change to patients as I am taking over treatment? I want to retain the patients because this practice has been around for 40 years. Also, there have not been full mouth series taken either. This will definitely be a new element for all of the staff as we move along with the transition.

ANSWER FROM CHRIS SALIERNO:
Changing treatment protocols when you take over for a dentist is tricky. You must always follow the appropriate guidelines and should never compromise care simply because the previous dentist did so. But, of course, the real challenge is explaining this to patients.

Here are a few things to consider:

(1) Make the selling dentist part of the solution. If the selling dentist will be around after the sale, he or she should be the one telling patients that your protocols are necessary for proper treatment. This can be done in-person as patients come in for their recall visits and it can also be done with a letter. Selling dentists are supposed to be writing a personal letter to patients introducing you, and your updated treatment protocols can be highlighted in the letter. The selling dentist can do all of this without incriminating himself or herself. Here’s an example: "I'm thrilled to transition your care to Dr. Chris Salierno. He is bringing the latest technology and research to this practice. For example, he is closely following the American Dental Association's latest guidelines for dental imaging, and I agree with him."

(2) Get the office team on your side. The front desk, hygienists, and assistants should be swayed to your side about updated radiographs. In many regards these folks probably know the patients even better than the selling dentist. They should be taught why your protocols are more appropriate, and they should agree to help you present this to patients. You should not be the only one telling patients they are due for a full mouth series!

(3) Create a script. When you do find a patient who is resistant to taking radiographs, have a prepared response that will help you consistently present your rationale. You may also want to present the ADA's guidelines as proof that you are not just making this stuff up. An example: "Dr. X took great care of you for the past 20 years and I'm honored to now assume that responsibility. According to the American Dental Association, we're a bit overdue for taking a standard series of dental images. I take your oral health very seriously and I want to make sure adhere to the latest guidelines." From there, you can address their specific concerns and show them how frequently they should be receiving radiographs moving forward.

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Editor's note: This content was originally published in 2017 and has been updated as of November 2025.